Computer-controlled endoscopic performance assessment system

Abstract

We have devised an advanced computer-controlled system (ADEPT) for the objective evaluation of endoscopic task performance. The system's hardware consists of a dual gimbal mechanism that accepts a variety of 5.0-mm standard endoscopic instruments for manipulation in a precisely mapped and enclosed work space. The target object consists of a sprung base plate incorporating various tasks. It is covered by a sprung perforated transparent top plate that has to be moved and held in the correct position by the operator to gain access to the various tasks. Standard video endoscope equipment provides the visual interface between the operator and the target-instrument field. Different target modules can be used, and the level of task difficulty can be adjusted by varying the manipulation, elevation, and azimuth angles. The system's software is designed to (a) prompt the surgeon with the information necessary to perform the task, (b) collect and collate data on performance during execution of specified tasks, and (c) save the data for future analysis. The system was alpha and beta tested to ensure that all functions operated correctly.

Methods and Tools for Objective Assessment of Psychomotor Skills in Laparoscopic Surgery

“…In a majority, they are used to record both the position (x, y, z coordinates) and orientation (yaw, pitch and roll) of the surgical instruments. In this review, the following systems are considered: ADEPT [92], ICSAD [52] (which measures hand movements rather than instrumenta position), CELTS [45], Zebris [48], TrEndo [93], ARH [94], HUESAD [47] and BlueDRAGON (which also measures forcé parameters) [95].…”

Laparoscopic vascular anastomoses: does robotic (Zeus–Aesop) assistance help to overcome the learning curve?

“…Other means for evaluating surgical accuracy objectively have been described. Motion tracking of instrument tips or upper limbs of the surgeon probably are good alternatives for evaluating efficacy and learning curves [9,18,19].…”

Laparoscopic skills training and assessment

“…The ICSAD device has also been shown objectively to assess the acquisition of psychomotor skill of trainees attending laparoscopic training courses 62,63 . The Advanced Dundee Endoscopic Psychomotor Tester (ADEPT) is another computer-controlled device, consisting of a static dome enclosing a defined workspace, with two standard laparoscopic graspers mounted on a gimble mechanism 64 . Within the dome is a target plate containing innate tasks, overlaid by a spring-mounted perspex sheet with apertures of varying shapes and sizes.…”