Viewpoint matters: objective performance metrics for surgeon endoscope control during robot-assisted surgery

Area of Science:

• Surgical Education and Training
• Robotics in Surgery
• Medical Simulation

Background:

• Effective visualization is crucial for surgical safety and training.
• Existing proficiency metrics (time, errors) need complementary measures.
• Robot-assisted minimally invasive surgery (RAMIS) offers unique data-driven feedback through camera adjustments.

Purpose of the Study:

• To validate novel camera metrics for robot-assisted minimally invasive surgery (RAMIS).
• To quantify the importance of these camera metrics in assessing surgeon proficiency.
• To explore the correlation between camera metrics and established efficiency measures.

Main Methods:

• 18 new, 8 intermediate, and 13 experienced surgeons participated.
• Surgeons completed 25 virtual reality simulation exercises using the da Vinci Surgical System.
• Three novel camera metrics were computed and compared with conventional efficiency metrics.

Main Results:

• Camera metrics demonstrated construct validity across most exercises (23/25 for movement frequency, 22/25 for duration, 19/25 for interval).
• Camera metrics effectively differentiated between new and experienced surgeons, similar to efficiency metrics.
• Camera metrics significantly correlated with completion time and overall score in most exercises.

Conclusions:

• Novel camera metrics are valid and correlate with efficiency metrics in RAMIS simulations.
• These camera metrics can differentiate surgeon skill levels.
• Camera metrics hold potential for improving proficiency-based curricula in RAMIS.