Eyes and movement differences in unconscious state during microscopic procedures

Area of Science:

• Surgical Education
• Microsurgery Techniques
• Human Factors in Surgery

Background:

• Microsurgical skill acquisition relies heavily on experience, yet training opportunities and standardized evaluations are limited.
• Understanding the physical and cognitive differences between expert and novice microsurgeons is crucial for developing effective training programs.

Purpose of the Study:

• To investigate the physical characteristics, specifically eye movements and muscle activity, of experienced versus novice surgeons during microsurgical suturing.
• To propose improved educational strategies for microsurgical skill development and assessment based on observed differences.

Main Methods:

• Comparative analysis of eye-tracking data and surface electromyography (sEMG) from expert (hand and orthopedic surgeons) and novice groups performing standardized suturing tasks.
• Quantitative assessment of viewpoint distribution, pupil dilation, gaze-hand movement synchrony, and muscle synergy.

Main Results:

• Novice surgeons (Group N) displayed a significantly larger viewpoint distribution area compared to expert surgeons (Group E) (p < 0.01).
• Expert surgeons (Group E) demonstrated more controlled pupil dilation, reduced standard deviation in gaze-hand movement distance (particularly gaze), and utilized muscle synergy for movement.
• Distinct patterns in eye movements and subconscious motor control were identified between experienced and novice microsurgeons.

Conclusions:

• Significant differences exist in visual attention and unconscious motor control between experienced and novice surgeons during microscopic suturing.
• These findings provide a basis for developing objective, experience-based training and evaluation tools for microsurgical skills.
• Objective measurement of eye and muscle activity can inform more efficient microsurgical education.