Assessment of open surgery suturing skill: Simulator platform, force-based, and motion-based metrics

Area of Science:

• Surgical Education
• Biomedical Engineering
• Medical Simulation

Background:

• Assessing open surgery suturing skill is crucial for surgical training.
• Current assessment methods may lack objective, quantifiable metrics.
• The Fundamentals of Vascular Surgery (FVS) provides a standardized suturing task.

Purpose of the Study:

• To introduce a novel surgical simulator for objective assessment of open surgery suturing skill.
• To develop and validate metrics derived from synchronized multi-modal data.
• To evaluate the simulator's ability to differentiate skill levels.

Main Methods:

• A new surgical simulator was developed, capturing synchronized force, motion, video, and touch data.
• A radial suturing task, adapted from FVS, was performed on the simulator.
• Objective metrics were extracted from needle tracking, force/torque, motion, and physical contact data.

Main Results:

• Statistically significant differences were found in force metrics (e.g., maximum force/torque in z-direction).
• Motion metrics (yaw, pitch, roll) and physical contact metrics also showed significant differentiation.
• Image-enabled force metrics (orthogonal and tangential forces) proved effective in distinguishing skill levels.

Conclusions:

• The developed surgical simulator provides objective metrics for suturing skill assessment.
• The metrics are sensitive to differences in skill between attending surgeons and residents.
• This simulator and its metrics show potential as a valuable tool for surgical training and education.