Objective performance indicators provide a novel, quantitative method to evaluate surgeon proficiency in robotic...

Area of Science:

• Robotic surgery
• Thoracic surgery
• Surgical education

Background:

• Current robotic surgeon proficiency assessment is subjective.
• Robotic platforms generate objective performance indicators (OPIs) from kinematic data.
• OPIs offer a granular, data-driven approach to evaluating surgical skill.

Purpose of the Study:

• To compare robotic surgeon proficiency during lobectomies across different training levels.
• To investigate the utility of OPIs in differentiating expert and trainee performance.
• To assess the feasibility of integrating kinematic data into clinical surgeon assessment.

Main Methods:

• Analysis of robotic lobectomies performed by expert surgeons and their trainees.
• Utilized OPI recorders to capture kinematic data during procedures.
• Segmented cases into standardized steps and assigned surgeons based on console activity.
• Compared kinematic data, including camera clutching, hand use ratio, and instrument speed, between groups.

Main Results:

• Expert surgeons exhibited significantly higher rates of camera clutching per minute (2.94 vs 2.52, P=.0005).
• Trainees showed a significantly greater ratio of right to left hand use (1.52 vs 1.48, P=.0047).
• Average instrument speed was significantly faster in expert surgeons (1.24 vs 1.13 m/min, P=.0061).
• These differences persisted even when trainees were subgrouped into junior and senior residents.

Conclusions:

• Significant differences in OPIs exist between expert and beginner robotic surgeons.
• Kinematic performance data can be effectively incorporated into thoracic surgeon assessment.
• This study validates the use of OPIs for objective evaluation of robotic surgical proficiency.