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Usefulness of an optical tracking system in laparoscopic surgery for motor skills assessment
Juan A Sánchez-Margallo1, Francisco M Sánchez-Margallo2, José B Pagador Carrasco1
1Unidad de Bioingeniería y Tecnologías Sanitarias, Centro de Cirugía de Mínima Invasión Jesús Usón, Cáceres, España.
Introduction:
The objective of this study is to assess the usefulness of an evaluation system of surgical skills based on motion analysis of laparoscopic instruments.
Method:
This system consists of a physical laparoscopic simulator and a tracking and assessment system of technical skills in laparoscopy. Six surgeons with intermediate experience (between 1 and 50 laparoscopic surgeries) and 5 experienced surgeons (more than 50 laparoscopic surgeries) took part in this study. All participants were right-handed. The subjects performed 3 repetitions of a cutting task on synthetic tissue with the right hand, dissection of a gastric serous layer, and a suturing task in the dissection previously done. Objective metrics such as time, path length, speed of movements, acceleration and motion smoothness were analyzed for the instruments of each hand.
Results:
In the cutting task, experienced surgeons show less acceleration (P=.014) and a smoother motion (P=.023) using the scissors. Regarding the dissection activity, experienced surgeons need less time (P=.006) and less length with both instruments (P=.006 for dissector and P=.01 for scissors). In the suturing task, experienced surgeons require less time (P=.037) and distance travelled (P=.041) by the dissector.
Conclusions:
This study shows the usefulness of the evaluation system for the cutting, dissecting, and suturing tasks. It represents a significant step in the development of advanced systems for training and assessment of surgical skills in laparoscopic surgery.
