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Video-Based Assessment of Operative Competency in Laparoscopic Cholecystectomy: A Prospective Observational Study to
Yuchen Luo1,2, Yuen Chiu Kang1, Ankur Sidhu1
1Division of Surgery, Northern Health, Epping, Victoria, Australia.
ANZ Journal of Surgery
|November 28, 2025
Summary
This pilot study shows potential for an objective video-based tool to assess laparoscopic cholecystectomy (LC) performance. Quantitative metrics demonstrated reliable interrater agreement, paving the way for AI-driven surgical skill evaluation.
Area of Science:
- Surgical Education
- Medical Technology
- Artificial Intelligence in Surgery
Background:
- Objective assessment of surgical skills is crucial for training.
- Current evaluation methods for laparoscopic cholecystectomy (LC) can be subjective.
- Developing reliable tools is essential for improving surgical competency.
Purpose of the Study:
- To assess interrater reliability of quantitative video-based measures for LC performance.
- To explore the potential for an objective assessment tool using artificial intelligence (AI).
Main Methods:
- 30 LC videos were evaluated by three surgeon assessors.
- Quantitative metrics included categorical and numerical items.
- Interrater reliability was measured using percent agreement (PA) and intraclass correlation coefficient (ICC).
Main Results:
- Moderate to excellent interrater agreement was found for various quantitative metrics.
- Registrars showed longer times to critical view of safety and more instrument insertions.
- Competency ratings indicated 45.8% of registrars were 'developing'.
Conclusions:
- Quantitative video-based assessment shows promise for objective evaluation of LC.
- Further research in AI and computer vision can enhance reliable surgical scoring tools.
- This pilot study supports the development of AI-assisted surgical skill assessment.
