Quantification of motion characteristics and forces applied to tissues during suturing

Area of Science:

• Surgical Education
• Motor Learning
• Biomechanical Analysis

Background:

• Quantification of movement processes provides feedback for motor learning.
• Process measures can be applied to teach fundamental surgical technical skills.
• This study investigates process measures of hand motions and forces during suturing.

Purpose of the Study:

• To determine if specific process measures of hand motions and forces during suturing are sensitive to practice.
• To determine if specific process measures of hand motions and forces during suturing are sensitive to levels of surgical expertise.

Main Methods:

• Six junior surgical residents and seven faculty surgeons performed 20 simulated sutures.
• Hand movements were tracked using electromagnetic markers; forces were measured by a force platform.
• Evaluated wrist rotation, hand velocity, applied forces, force-rotation onset timing, and suturing time.

Main Results:

• Faculty surgeons exhibited greater wrist rotation, higher average forces, shorter force-rotation initiation times, and reduced suturing times compared to junior residents.
• Junior residents showed improvement in wrist rotation and force-rotation initiation time with practice.

Conclusions:

• Four measured variables distinguished between expert and novice suturing performance.
• Wrist rotation and force-rotation initiation time improved with practice in junior residents.
• These process measures can provide structured feedback to facilitate surgical skills acquisition.