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Evaluating robotic-assisted partial nephrectomy surgeons with fully convolutional segmentation and multi-task

Yihao Wang1, Zhongjie Wu1, Jessica Dai2

  • 1Department of Computer Science, Southern Methodist University, Dallas, USA.

Journal of Robotic Surgery
|June 27, 2023
PubMed
Summary

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Machine learning models assess surgical skill in robotic assisted partial nephrectomy (RAPN) using video analysis. The system accurately predicts proficiency scores but requires more diverse data for improved accuracy.

Area of Science:

  • Robotics in Surgery
  • Machine Learning Applications
  • Surgical Education Technology

Background:

  • Robotic assisted partial nephrectomy (RAPN) is a complex procedure requiring high surgical skill.
  • Objective evaluation of surgical skill is crucial for training and quality improvement.
  • Previous studies often utilized synthetic environments, limiting real-world applicability.

Purpose of the Study:

  • To develop and evaluate machine learning models for assessing surgical skill from actual RAPN procedure videos.
  • To predict surgical proficiency scores, specifically OSATS (Objective Structured Assessment of Technical Skills) and GEARS (Global Evaluative Assessment of Robotic Skills).
  • To investigate the use of cascaded neural networks for instrument tracking and skill scoring.

Main Methods:

Keywords:
Convolutional networkMulti-task learningSelf-attentionSurgical assessment

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  • Utilized videos from DaVinci robotic systems during tumor resection and renography steps of RAPN.
  • Employed cascaded neural networks, including a semantic segmentation network for instrument tracking.
  • A scoring network processed instrument movements to predict OSATS and GEARS scores for various subcategories.

Main Results:

  • The model demonstrated good performance in predicting subcategory scores for metrics like force sensitivity and instrument knowledge.
  • The system successfully tracked surgical instruments within the operative field.
  • Identified limitations including false positives/negatives, attributed to limited training data variability and sparsity.

Conclusions:

  • Machine learning can effectively evaluate surgical skill from real-world RAPN videos.
  • The developed cascaded neural network approach shows promise for automated surgical skill assessment.
  • Further research with larger and more diverse datasets is needed to enhance model robustness and accuracy.