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[155] Citation: Abstract
Minimally invasive surgery (MIS) involves a multi-dimensional
series of tasks requiring a synthesis between visual information and
the kinematics and dynamics of the surgical tools. Analysis of these
sources of information is a key step in mastering MIS surgery but may
also be used to define objective criteria for characterizing surgical
performance. The BlueDRAGON is a new system for acquiring the
kinematics and the dynamics of two endoscopic tools along with the
visual view of the surgical scene. It includes two four-bar mechanisms
equipped with position and force torque sensors for measuring the
positions and the orientations (P/O) of two endoscopic tools along
with the forces and torques applied by the surgeon's hands. The
methodology of decomposing the surgical task is based on a fully
connected, finite-states (28 states) Markov model where each states
corresponded to a fundamental tool/tissue interaction based on the
tool kinematics and associated with unique F/T signatures. The
experimental protocol included seven MIS tasks performed on an animal
model (pig) by 30 surgeons at different levels of their residency
training. Preliminary analysis of these data showed that major
differences between residents at different skill levels were: (i) the
types of tool/tissue interactions being used, (ii) the transitions
between tool/tissue interactions being applied by each hand, (iii)
time spent while performing each tool/tissue interaction, (iv) the
overall completion time, and (v) the variable F/T magnitudes being
applied by the subjects through the endoscopic tools. Systems like
surgical robots or virtual reality simulators that inherently measure
the kinematics and the dynamics of the surgical tool may benefit from
inclusion of the proposed methodology for analysis of efficacy and
objective evaluation of surgical skills during training
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Updated: Tue Jul 15 23:54:51 2008
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