Influence of Surgical Expertise on Visual Gaze Patterns While Viewing a Robotic Adrenalectomy

Area of Science:

• Robotic surgery
• Surgical education
• Visual perception

Background:

• Understanding visual perception differences between surgeons of varying expertise is crucial for improving surgical training.
• Robotic adrenalectomy presents complex visual challenges that may be perceived differently by surgeons based on experience.

Purpose of the Study:

• To quantify and understand disparities in visual perception during robotic adrenalectomy between early-career and senior surgeons.
• To analyze how surgical expertise influences gaze patterns and attention to specific procedural events.

Main Methods:

• A cross-sectional observational study involving 15 surgeons (10 early-career, 5 senior) viewing a robotic adrenalectomy video.
• Eye-tracking data collected using Tobii Pro Fusion to analyze fixation duration and count on defined areas of interest (AOIs).
• Surgeons categorized by experience level; data analyzed across procedural steps.

Main Results:

• Gaze patterns significantly differed across procedural steps and between expertise groups (p < 0.001).
• Early-career surgeons showed longer fixation durations on instruments during critical steps like vein dissection (p=0.031) and ultrasonic dissection (p=0.049).
• Senior surgeons displayed more distributed gaze patterns, suggesting a wider contextual visual understanding.

Conclusions:

• Senior surgeons possess a more comprehensive visual understanding of robotic adrenalectomy, enabling attention to both instruments and surrounding structures.
• Eye-tracking technology can identify specific visual learning needs in novice surgeons.
• Integrating eye-tracking into surgical education can enhance procedural perception and training for future surgeons.