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Objective Performance Indicators Differ Between Expert Versus Novice Surgeons During Robotic Proctectomy.

Mishal Gillani1, Usama Waqar1, Manali Rupji2

  • 1Department of Surgery, Emory University School of Medicine, Atlanta, Georgia.

The Journal of Surgical Research
|July 27, 2025
PubMed
Summary

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This summary is machine-generated.

Objective performance indicators (OPIs) reveal differences in surgical skill between expert and novice surgeons during robotic proctectomy (RP). These metrics can objectively assess surgeon expertise and guide training.

Area of Science:

  • Robotic surgery
  • Surgical skill assessment
  • Machine learning in medicine

Background:

  • Objective performance indicators (OPIs) derived from robotic systems offer potential for evaluating surgical skill.
  • Limited research exists on OPIs in colorectal surgery, specifically robotic proctectomy (RP).

Purpose of the Study:

  • To identify specific OPIs that differentiate expert and novice surgeons during robotic proctectomy.
  • To establish objective metrics for surgical skill in RP.

Main Methods:

  • Analysis of synchronized endoscopic videos and robotic system data from 30 robotic proctectomies.
  • Comparison of 541 critical surgical steps across 2 expert and 11 novice surgeons.
  • Evaluation of OPIs including camera and arm movements, instrument handling, and energy application.
Keywords:
Objective performance indicatorProctectomyRobotic surgerySurgical data scienceSurgical expertiseSurgical training

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Main Results:

  • Significant differences in OPIs were observed between expert and novice surgeons across all analyzed steps.
  • Experts demonstrated distinct movement patterns, including greater velocity/acceleration, fewer arm swaps, and optimized instrument usage.
  • Specific OPIs like wrist articulation and path length varied significantly with expertise during key dissection phases.

Conclusions:

  • Step-specific OPIs effectively distinguish between expert and novice surgeons in robotic proctectomy.
  • Validated OPIs can serve as objective tools for performance benchmarking, surgical training, and credentialing.