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[199] Citation: Abstract
Minimally invasive surgery (MIS) involves a multidimensional
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 defining objective
criteria for characterizing surgical performance. The Blue
DRAGON is a new system for acquiring the kinematics and the dynamics
of two endoscopic tools synchronized with the endoscopic
view of the surgical scene. Modeling the process of MIS using a finite
state model [Markov model (MM)] reveals the internal structure
of the surgical task and is utilized as one of the key steps in
objectively assessing surgical performance. The experimental protocol
includes tying an intracorporeal knot in a MIS setup performed
on an animal model (pig) by 30 surgeons at different levels
of training including expert surgeons. An objective learning curve
was defined based on measuring quantitative statistical distance
(similarity) between MM of experts and MM of residents at different
levels of training. The objective learning curve was similar
to that of the subjective performance analysis. The MM proved to
be a powerful and compact mathematical model for decomposing
a complex task such as laparoscopic suturing. Systems like surgical
robots or virtual reality simulators in which the kinematics and the
dynamics of the surgical tool are inherently measured may benefit
from incorporation of the proposed methodology.
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Updated: Tue Jul 15 23:54:51 2008
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