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[157] 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 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 synchronized
with the visual view of the surgical scene. It includes two four-bar
passive 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 (F/T) applied by the surgeon's
hands. The methodology of decomposing the surgical task is based on a
fully connected, 28 finite-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 including expert surgeons. 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 Aug 19 09:16:09 2008
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