Intraoperative tremor in surgeons and trainees.

Area of Science:

• Surgical Simulation
• Biomechanics
• Motor Control

Background:

• Quantifying surgeon tremor during complex tasks is challenging.
• Physiological tremor can impact fine motor skills, particularly in surgery.
• Assessing tremor during simulated procedures is crucial for training and performance evaluation.

Purpose of the Study:

• To quantify tremor during realistic simulated surgery.
• To develop a novel method for measuring tremor transmission in a surgical context.
• To investigate potential learning effects in tremor reduction during simulated surgical tasks.

Main Methods:

• Utilized a novel surgical simulator with an integrated force sensor to measure tremor effects on the manipulandum.
• Collected data from trainees and experienced surgeons performing simulated distal coronary anastomoses on silicone vessels.
• Calculated transient and overall tremor intensity and analyzed for learning effects.

Main Results:

• Observed oscillations (8-12 Hz) attributed to enhanced physiological tremor in force data.
• Demonstrated a significant reduction in tremor transmission from the first to later surgical simulation attempts (P = 0.039).
• Observed a large effect size (0.91) for tremor reduction, potentially linked to increased surgeon confidence.

Conclusions:

• Developed a method to quantify tremor transmission to the manipulandum during high-fidelity simulated surgery.
• This technique can assess and provide feedback on surgeon performance, benefiting both trainees and experienced surgeons.
• The method has potential applications in evaluating fine motor skills in various critical fields beyond surgery.