Laparoscopic Surgery Skills Evaluation: Analysis Based on Accelerometers

Abstract

Background and Objective:Technical skills assessment is considered an important part of surgical training. Subjective assessment is not appropriate for training feedback, and there is now increased demand for objective assessment of surgical performance. Economy of movement has been proposed as an excellent alternative for this purpose. The investigators describe a readily available method to evaluate surgical skills through motion analysis using accelerometers in Apple's iPod Touch device.Methods:Two groups of individuals with different minimally invasive surgery skill levels (experts and novices) were evaluated. Each group was asked to perform a given task with an iPod Touch placed on the dominant-hand wrist. The Accelerometer Data Pro application makes it possible to obtain movement-related data detected by the accelerometers. Average acceleration and maximum acceleration for each axis (x, y, and z) were determined and compared.Results:The analysis of average acceleration and maximum acceleration showed statistically significant differences between groups on both the y (P = .04, P = .03) and z (P = .04, P = .04) axes. This demonstrates the ability to distinguish between experts and novices. The analysis of the x axis showed no significant differences between groups, which could be explained by the fact that the task involves few movements on this axis.Conclusion:Accelerometer-based motion analysis is a useful tool to evaluate laparoscopic skill development of surgeons and should be used in training programs. Validation of this device in an in vivo setting is a research goal of the investigators' team.

Preliminary design and evaluation of a remote tele-mentoring system for minimally invasive surgery

“…Under the assumption that both mentor and mentee have comparable surgical macro-skills (such as general expertise in anatomy, maneuvering of surgical instruments, ability to identify surrounding critical structures, and judge tissue thickness), the proposed system is primarily expected to be helpful in scenarios where the mentor remotely guides a less experienced mentee in performing a newly developed surgical technique. The mentee may not have perfected the technique-relevant micro-skills (such as visual tactility, economy of movement, and tissue handling [ 32 , 33 ]) and the overlaid virtual surgical instruments may expedite the learning. Additionally, since standard operating procedures do not currently exist for tele-collaborative surgical initiatives, the proposed system of augmentation could assist in establishing correlation between taxonomy and surgical tool movements.…”

LAPKaans: Tool-Motion Tracking and Gripping Force-Sensing Modular Smart Laparoscopic Training System

“…However, most of the related work shows concepts with significant complexity compared to the work reported here. These added elements of complexity to track motion involve: (a) use of sensors attached to the instrument´s tip that distort the original design of the laparoscopic instrument [35][36][37][38][39][40]; (b) use of complex systems that require special calibration or the placement of the sensors in a specific location of the room [41,42]; (c) placement of elements on the surgeon's body [43,44]. These specific locations of the systems may impede proper tool motion and positioning [40].…”

Learning curves in surgery: variables, analysis and applications

“…Simulation allows trainees to advance through or overcome their learning curves, achieving a level of competence in a controlled manner without compromising patient safety. The number of unnecessary movements (economy of movement score) in simulated laparoscopic skills is often used as a process outcome to assess learning 31. Video recording of simulations can be used for formative and summative assessment 32…”