Skill Assessment and Visualization System for Endoscopic Sinus Surgery : a Clinical Study

Abstract

Endoscopic sinus surgery(ESS)is one of the most common surgeries performed for chronic sinusitis, but it carries a high risk of damaging adjacent organs, such as the skull base and orbit 1) . To minimize this risk, ESS is often performed utilizing an optical or magnetic surgical navigation system. However, there are still many reports of complications included CSF leak, diplopia, postoperative hemorrhage 2) ,3) . Skill learning support is necessary for the improvement of surgical outcomes. In recent years, there are many studies have been reported on ESS education methods using a sim-ulator based on real anatomical models or Virtual Reality (VR) . Abdulaziz et al. developed a 3D-printed model based on CT images of the patient for the training of ESS skills 4) . Also, there are many VR simulators with haptic feedback 5) ,6) . Samuel et al. developed a comparatively lowcost mixed-reality simulator combining VR and 3D-printed models 7) . In addition to the fact that the simulator can practice repeatedly, there are also a report that the experience level of the surgeon and the result of the simulator have a positive correlation 6) . Therefore, it can be said that simulator training is a useful training tool for resident. However, it is pointed out that there are few products that currently have been commercialized and they are very expensive, and there is no platform that can be widely used in training programs 8) -10) . Although the importance of training using a simulator is increasing, the traditional On the Job Training (OJT)is still important 9) ,11) . The traditional apprenticeship

Development of recognised position‐guided navigation system

“…Given the recent widespread use of laparoscopic surgery, some researchers attempted evaluation based on the number of times forceps are inserted and extracted and the trajectory of forceps' tips 19‐21 . Also some researchers reported on the evaluation of surgical skills in the otolaryngology field 22 . In the present study, the operation time during which the tips remained within the optimal dissection area was used to quantify skill levels, which may be useful in future studies.…”

Clinical study of skill assessment based on time sequential measurement changes

“…The aim of this study was to further develop the time-series comparative analysis method into a multifaceted analysis focused on the motion and position information of the surgical instruments. Furthermore, we aimed to verify the method by increasing the amount of data over the amount used in previous studies 6 , 7 . As indicated in Fig.…”

“…The surgical features, defined in a previous study 6 , are listed in Table 2 . is the position of the instrument tip in the i th frame .…”

“…In addition, we used the positional information of surgical instruments. At this juncture, we set a new coordinate system relative to the nasal anatomy, as described in a previous study 6 (Fig. 2 ) because the size of the nasal cavities varied among patients.…”

“…Sugino et al 6 previously focused on positional information of surgical instruments during surgery and developed a time-series comparative analysis method. However, this method did not focus on detecting the erroneous aspects of the surgery.…”