Skills Evaluation in Minimally Invasive Surgery Using Force/Torque Signatures

Richards, C. and Rosen, J. and Hannaford, B. and MacFarlane, M. and Pellegrini, C. and Sinanan, M. (2000) Skills Evaluation in Minimally Invasive Surgery Using Force/Torque Signatures. Surgical Endoscopy, 14 (9). pp. 791-798.

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Background: One of the more difficult tasks in surgical education is to teach the optimal application of instrument forces and torques necessary to facilitate the conduct of an operation. For laparoscopic surgery, such training has traditionally taken place in the operating room, reducing operating room efficiency and potentially affecting the safe conduct of the operation. Objective: The objective of the current study was to measure and compare forces and torque signatures at the tool/hand interface generated during laparoscopic surgery by novice (NS) and experienced (ES) surgeons using a novel force-torque laparoscopic instrument. Methods: Four surgeons (2-NS, 2-ES) performed a cholecystectomy and Nissen fundoplication in a porcine model. An instrumented laparoscopic grasper with interchangeable standard surgical tips equipped with a three-axis force/torque sensor was used to measure the force/torque signature at the hand/tool interface. Force/torque data synchronized with visual view of the tool operative maneuvers were collected simultaneously via a novel graphic user interface incorporated picture-in-picture video technology. Subsequent frame by frame, video analysis of the operation allowed to define states within each step of the operation. Forces and torques measured within each state were further analyzed using vector quantization and the hidden Markov statistical model. Results: The NS group used a mean of 138 greater force and 130 greater torque during all stages of an operation compared to the ES group. Furthermore, the completion time of a laparoscopic cholecystectomy on a porcine model was 270 greater in the NS group. State analysis suggests that the majority of this time was consumed in an "idle" without useful contribution to the conduct of the operation. Conclusions: Preliminary data suggest that force/torque signatures provide an objective means of distinguishing novice from skilled surgeons. Clinical force/torque sigy may be helpful in both training and measuring technical proficiency during laparoscopic surgery.

Item Type: Article
Subjects: Z Other
Depositing User: Mohammad Haghighipanah
Date Deposited: 30 Jul 2015 17:58
Last Modified: 30 Jul 2015 17:58

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