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[142] Citation: Abstract
The best method of training for laparoscopic surgical skills is
controversial. Some
advocate observation in the operating room, while others promote animal and
simulated
models or a combination of surgery-related tasks. A crucial process in surgical
education is to evaluate the level of surgical skills. For laparoscopic
surgery,
skill evaluation is traditionally performed subjectively by experts grading a
video of a
procedure performed by a student. By its nature, this process uses fuzzy
criteria. The
objective of the current study was to develop and assess a skill scale using
Markov
Models (MM). Ten surgeons (5 Novice Surgeons - NS; 5 Expert Surgeons - ES)
performed
a cholecystectomy and Nissen fundoplication in a porcine model. An instrumented
laparoscopic grasper equiped with a three-axis force/torque sensor was used to
measure
the forces/torques (F/T) at the hand/tool interface synchronized with a video of
the tool operative maneuvers. A synthesis of frame-by-frame video analysis and
a vector
quantization algorithm, allowed to define force/torque signatues associated with
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Updated: Tue Jul 15 23:54:51 2008
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