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Enhanced Training Benefits of Video Recording Surgery With Automated Hand Motion Analysis.

Colin F Mackenzie1, Shiming Yang2, Evan Garofalo3

  • 1School of Medicine (UMDSOM) Shock Trauma Anesthesiology Research Center, University of Maryland, 11 S Paca St, Suite LL-01, Baltimore, MD, 21201, USA. cmack003@gmail.com.

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Summary

Surgical skill can be assessed unobtrusively using video analysis of hand motion, timing, and Shannon entropy. These metrics correlate with expert performance and can evaluate surgical training and quality assurance.

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Area of Science:

  • Surgical Skill Assessment
  • Medical Technology
  • Biomechanical Analysis

Background:

  • Video recording of surgical hand motion offers potential for evaluating surgical performance.
  • Technical skill in open surgery can be measured unobtrusively through video analysis during procedures.
  • Hypothesized that procedural timing, hand movements, instrument use, and Shannon entropy vary with expertise and correlate with validated performance scores.

Purpose of the Study:

  • To identify unobtrusive video-based methods for measuring technical skill in open surgery.
  • To determine if procedural-step timing, hand movements, instrument use, and Shannon entropy differentiate surgical expertise and training levels.
  • To validate these metrics against established performance-based individual procedure scores.

Main Methods:

  • Video recording of surgeons and non-surgeons performing axillary artery exposure and control on cadavers.
  • Utilized color-coded gloves for motion tracking and automated Shannon entropy data extraction.
  • Collected timing and instrument-use metrics via observational video review; analyzed speed, acceleration, and direction using computer-vision algorithms.

Main Results:

  • Expert surgeons exhibited lower entropy values, reduced idle and active times, and faster pectoralis minor division, using fewer instruments.
  • Surgical residents demonstrated improvement with training but did not reach expert levels, with performance declining 12-18 months later.
  • Individual procedure scores aligned with the observed skill and training-level differences; non-surgeons differed significantly.

Conclusions:

  • Hand motion entropy and timing metrics effectively discriminate surgical skill and training levels, correlating with individual procedure score evaluations.
  • These objective measures are collectible with consumer cameras and analyzable with free software, enabling widespread application.
  • Video-based hand motion and timing data can enhance resident performance evaluation and contribute to surgical education and quality assurance programs.