Review of methods for objective surgical skill evaluation

Reiley, Carol E.; Lin, Henry; Yuh, David D.; Hager, Gregory D.

doi:10.1007/s00464-010-1190-z

Cited by 211 publications

(171 citation statements)

References 56 publications

Supporting

Mentioning

164

Contrasting

Unclassified

Order By: Relevance

“…The definition and equation of the analytical parameters are indicated in Table 2. Although parameters, such as total operating time or total path length of the surgical instrument, are often used for surgical skill assessment in similar studies 17) , these parameters were excluded to find features of endoscope manipulation that do not depend on the operating time, as it can be assumed that with more surgical experience, time-dependent parameters would become lower. All the analytical parameters used in this study were calculated from only the endoscope tracking information.…”

Section: Quantitative Analysis Of Endoscope Manipulation 221 Paramementioning

confidence: 99%

Quantitative Analysis of a Camera Operation for Endoscopic Sinus Surgery Using a Navigation Information : Clinical Study

Sugino

Nakamura

Kuboki

et al. 2017

JJSCAS

View full text Add to dashboard Cite

Advanced surgeries, such as endoscopic surgery, are widely performed, but it is difficult to achieve safety in these surgical procedures. For example, in the field of otolaryngology, although endoscopic sinus surgery（ESS） is commonly performed as a treatment for chronic sinusitis, ESS requires sophisticated psychomotor skills and a knowledge of the relationship of nasal sinuses to vulnerable adjacent structures（i.e., the orbit, or the base of . Thus, an image-guided navigation system is increasingly used to enhance the safety of ESS. However, as reported in the literature 2) , complications related to ESS still occur despite the use of the navigation system. In order to enhance the safety of this surgery further, it is essential to improve surgeonsʼ levels of the relevant knowledge and skills. Therefore, methods for quantitatively measuring, analyzing, and evaluating surgical tasks or workflow are increasingly being proposed 3) . These approaches can be AbstractA high level of surgical skill is required for endoscopic sinus surgery（ESS), a procedure that involves the nasal sinus, which is adjacent to important organs, without injury. However, it is difficult to assess such surgery quantitatively in a clinical environment. Thus, we employed a surgical navigation system that is currently used in ESS, and have developed a method to assess surgical tasks by utilizing the navigation system as a recording medium. Previously, we had developed a method for analyzing the manipulation of an endoscope, which is an important aspect of ESS, using this navigation system, based on simulated surgeries. Here, we established a method for measuring and analyzing endoscope manipulation during clinical image-guided ESS. In this study, we analyzed 8 clinical cases, in which expert surgeons treated one nasal cavity, and resident surgeons treated the contralateral cavity, by ESS. In order to clarify the features of endoscopic manipulation by experts and residents in detail, we performed principal component analysis as well as time-series analysis using the analytical parameters derived from information stored on the navigation system. Our proposed method enabled quantitative evaluation of the performance of endoscopic manipulation during ESS in a clinical environment.

show abstract

Section: Quantitative Analysis Of Endoscope Manipulation 221 Paramementioning

confidence: 99%

Quantitative Analysis of a Camera Operation for Endoscopic Sinus Surgery Using a Navigation Information : Clinical Study

Sugino

Nakamura

Kuboki

et al. 2017

JJSCAS

View full text Add to dashboard Cite

show abstract

“…Empirical evidence suggests that the level of technical expertise is represented by the proper handling of surgical equipment in such a way that this is efficient and minimizes the risk for errors occurring. 97,98 In addition, virtually all established endovascular GRS and checklists contain criteria, that evaluate three key technical attributes, summarized as: 1) avoiding vessel wall damage with precise catheter manipulation, especially near delicate or sclerotic areas; 2) smooth timely catheter navigation without unnecessary movements; 3) efficient use of the imaging modalities and contrast agents. Inspired by this, we expanded skill assessment by focusing on 1) and 2) and hypothesized that quantitative measures extracted from analyzing medical images and tracking the instruments trajectory, combined appropriately, will contain the necessary information to discriminate experience levels.…”

Section: Skill Assessmentmentioning

confidence: 99%

Cognitive AutonomouS CAtheters Operating in Dynamic Environments

Poorten

Tran

Devreker

et al. 2016

J. Med. Robot. Res.

View full text Add to dashboard Cite

Advances in miniaturized surgical instrumentation are key to less demanding and safer medical interventions. In cardiovascular procedures interventionalists turn towards catheter-based interventions, treating patients considered unfit for more invasive approaches. A positive outcome is not guaranteed. The risk for calcium dislodgement, tissue damage or even vessel rupture cannot be eliminated when instruments are maneuvered through fragile and diseased vessels. This paper reports on the progress made in terms of catheter design, vessel reconstruction, catheter shape modeling, surgical skill analysis, decision-making and control. These efforts are geared towards the development of the necessary technology to autonomously steer catheters through the vasculature, a target of the EU-funded project CASCADE (Cognitive AutonomouS CAtheters operating in Dynamic Environments). Whereas autonomous placement of an aortic valve implant forms the ultimate and concrete goal, the technology of individual building blocks to reach such ambitious goal is expected to be much sooner impacting and assisting interventionalists in their daily clinical practice.

show abstract

“…Structured human grading is an extension of the traditional observational approach where a senior surgeon observes a student and provides verbal feedback. In multiple surgical fields, structured grading techniques often attempt to standardize evaluation through rated checklists that assess performance of fundamental tasks on inanimate bench top models [17]. The Global Rating Scale for Endovascular Performance (GRSEP) is a structured grading tool that is used by a senior clinician to assess each subject based on their performance in endovascular skills.…”

Section: Performance Assessmentmentioning

confidence: 99%

On the development of objective metrics for surgical skills evaluation based on tool motion

Estrada

O’Malley

Duran³

et al. 2014

2014 IEEE International Conference on Systems, Man, and Cybernetics (SMC)

View full text Add to dashboard Cite

Abstract-A key competency requirement in endovascular surgery is to optimally visualize and utilize pre-shaped catheters to navigate complex vascular anatomy, yet current performance assessment techniques are limited to grading scales based solely on observation. Since most endovascular procedures involve performing fine motor control tasks that require complex, dexterous movements, this paper explores the potential for a standardized, objective, and quantitative means of measuring technical competence based on analysis of the kinematics of endovascular tool tip motions. To accomplish this goal, we recorded catheter tip movement from twenty subjects performing fundamental endovascular tasks in an inanimate model and in a simulation environment with a virtual representation of the same inanimate model. Several motionbased performance measures that have been shown to reliably assess skill in other domains were computed and tested for correlation with data that were obtained from the global rating scale assessment tool. The metrics that quantified movement quality by assessing movement smoothness produced reliable correlations with the observation-based assessment metrics. These objective and quantitative metrics that capture movement quality could be incorporated into future training protocols to provide detailed feedback on trainee performance.

show abstract

Review of methods for objective surgical skill evaluation

Cited by 211 publications

References 56 publications

Quantitative Analysis of a Camera Operation for Endoscopic Sinus Surgery Using a Navigation Information : Clinical Study

Quantitative Analysis of a Camera Operation for Endoscopic Sinus Surgery Using a Navigation Information : Clinical Study

Cognitive AutonomouS CAtheters Operating in Dynamic Environments

On the development of objective metrics for surgical skills evaluation based on tool motion

Contact Info

Product

Resources

About