Spatiotemporal characteristics of eye-hand coordination among different skill levels in laparoscopic surgery

Efficient eye-hand coordination is fundamental to surgical proficiency, particularly in minimally invasive surgeries. A comprehensive analysis of eye-hand coordination across varying surgical skill levels is essential for evaluating surgical task proficiency and establishing a basis for objective surgical skill assessment and training.

Eighteen participants, including five experts (attending general surgeons), five intermediates (surgical residents), and eight novices without prior surgical experience, were recruited in this study. Metrics such as gaze motion entropy, gaze-tooltip relative latency, and gaze-tooltip dynamic time warping (DTW) were employed to assess the irregularity of gaze motion and coordination between gaze and surgical instrument motion.

Experts had significantly lower gaze motion entropy than novices, reflecting more organized and predictable gaze behavior. Experts and intermediates also exhibited superior gaze and surgical instrument coordination than novices, as indicated by significantly lower gaze-tooltip DTW values for surgical instruments in both dominant and non-dominant hands. Furthermore, longer gaze-tooltip relative latency for the surgical instrument in the non-dominant hand among experts compared to novices suggests anticipatory gaze motion, i.e., eye-leading-hand behavior.

This study developed a spatiotemporal framework for analyzing eye-hand coordination, demonstrating that higher surgical skill levels are associated with lower gaze motion entropy, greater spatial coordination between gaze and instrument motion, and longer gaze-tooltip relative latency. These findings can contribute to objective surgical skill assessment and offer valuable insights for surgical training, potentially accelerating the learning curve for trainees.