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Development and validation of a sensor- and expert model-based training system for laparoscopic surgery: the iSurgeon
Karl-Friedrich Kowalewski1, Jonathan D Hendrie1, Mona W Schmidt1
1Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
Surgical Endoscopy
|September 9, 2016
Summary
The iSurgeon system effectively trains minimally invasive surgery skills, demonstrating validity and reliability. It identifies difficult steps like needle positioning to shorten learning curves for laparoscopic tasks.
Area of Science:
- Surgical training and simulation
- Minimally invasive surgery (MIS)
- Medical device development
Background:
- Minimally invasive surgery (MIS) has steep learning curves, necessitating effective training and assessment tools outside the operating room.
- Traditional training methods may not adequately prepare surgeons for the complexities of MIS procedures.
Purpose of the Study:
- To develop and validate a sensor- and expert model-based system, the iSurgeon, for laparoscopic surgical training.
- To assess the construct validity, concurrent validity, and test-retest reliability of the iSurgeon system.
Main Methods:
- Participants of varying experience levels (novice, intermediate, expert) performed standardized laparoscopic knot-tying tasks.
- Motion capture technology (NDI Polaris, Microsoft Kinect v1) tracked instrument and surgeon movements.
- Frame-by-frame image analysis identified key suturing and knot-tying steps, correlated with motion data.
- The Objective Structured Assessment of Technical Skills (OSATS) served as the gold standard for concurrent validity.
Main Results:
- The iSurgeon system demonstrated construct validity by significantly differentiating between experience levels across multiple parameters (time, path length, speed, angular path, movement count, joint angle range).
- Concurrent validity was established between iSurgeon parameters and OSATS scores.
- Test-retest reliability was confirmed for 7 out of 8 assessed parameters.
- Key learning challenges were identified as 'wrapping the thread around the instrument' and 'needle positioning'.
Conclusions:
- The iSurgeon system is a valid and reliable tool for laparoscopic surgical training.
- Utilizing multiple performance metrics enhances training assessment reliability.
- The system's ability to provide automated, real-time feedback based on expert models can potentially shorten learning curves for complex laparoscopic tasks.
- Future work includes implementing and evaluating full procedural training within an experimental model.
Keywords:
AssessmentComputer-assisted surgeryEducationKinectLaparoscopic suturing and knot tyingMinimally invasive surgery
