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Decoding surgical skill: an objective and efficient algorithm for surgical skill classification based on surgical

Zixin Chen^1,2, Dewei Yang³, Ang Li^1,4

¹Department of General Surgery, Division of Pancreatic Surgery.

International Journal of Surgery (London, England)

|December 11, 2023

Summary

This summary is machine-generated.

A new algorithm accurately assesses laparoscopic cholecystectomy skills using surgical gesture features. This tool aids in identifying surgeon competency and improving patient outcomes through objective feedback.

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Area of Science:

Surgical Education and Training
Medical Technology Assessment
Laparoscopic Surgery

Background:

Surgical skill variation impacts patient outcomes.
Objective assessment is crucial for surgical quality improvement.
Identifying less skilled surgeons enables targeted feedback and training.

Purpose of the Study:

To develop a novel algorithm for evaluating surgical skills in laparoscopic cholecystectomy.
To utilize elementary functional surgical gestures (Surgestures) for skill assessment.
To create an objective tool for classifying surgeon competency.

Main Methods:

Analysis of 75 laparoscopic cholecystectomy videos from 33 surgeons.
Annotation of surgical phases with 14 specific Surgestures.
Development of a classification algorithm using 63 Surgesture features.
Validation of the algorithm using the area under the receiver operating characteristic curve (0.866).

Main Results:

Perioperative factors showed limited correlation with surgical skill scores (mGOALS).
Incompetent surgeons exhibited a significantly higher rate of cholecystic vascular injury (30.8% vs 6.1%).
Competent surgeons used fewer inefficient Surgestures and demonstrated optimized dissection techniques.
The developed algorithm achieved high accuracy in classifying surgeon skill levels.

Conclusions:

A computer algorithm effectively classifies laparoscopic surgical skill levels based on objective Surgesture features.
This technology offers a pathway for developing automated surgical skill assessment tools.
Objective feedback derived from Surgesture analysis can enhance surgical training and patient safety.