Visual behaviour in robotic surgery-Demonstrating the validity of the simulated environment

Area of Science:

• Robotic Surgery
• Surgical Training
• Ophthalmology

Background:

• Eye metrics offer insights into surgical behavior and performance differentiation.
• Application of eye metrics in robotic surgery training remains unexplored.
• This study investigates eye metrics in novice robotic surgeons within simulated and real-world environments.

Purpose of the Study:

• To explore the utility of eye metrics in assessing robotic surgery performance.
• To correlate eye metrics with established performance assessment tools in robotic surgery training.
• To evaluate the differences in eye metrics between simulated and real tissue environments.

Main Methods:

• Novice robotic surgeons trained to proficiency using the da Vinci Si system and dVSS simulator.
• Eye-tracking glasses recorded surgeon eye metrics (pupil size, blinks, entropy) during training.
• Performance assessed using Global Evaluative Assessment of Robotic skills (GEARS) and numeric psychomotor test scores (NPMTS).

Main Results:

• Significant correlations observed between pupil size, rate of change, entropy, and GEARS/NPMTS scores in novice and proficient surgeons (P ≤ .05).
• The number of blinks per minute showed significant differences between simulated and real tissue environments.
• Pupilometrics demonstrated a strong link to established robotic surgery performance metrics.

Conclusions:

• Eye tracking serves as a valuable, objective physiological tool for robotic surgery assessment.
• Pupilometric data significantly correlates with traditional robotic surgery assessment methods.
• Eye-tracking metrics can be integrated into future robotic surgery training and evaluation protocols.