Diffuse reflectance spectroscopy as a novel tool for assessing laparoscopic surgical skills
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Updated: Nov 7, 2026
Diffuse Reflectance Spectroscopy: Getting the Capillary Refill Test Under One's Thumb
Published on: December 2, 2017
Grace Pickering1, Maxime Giot2, Kaizhong Deng2
1Department of Surgery and Cancer, Imperial College London, London, United Kingdom.
Background:
Minimally invasive surgeries are performed ubiquitously worldwide, and objective skill assessment measures are needed for effective training. Established metrics, such as the Global Operative Assessment of Laparoscopic Skills, rely on reviewers' expertise and are subject to inter-rater variability. Diffuse reflectance spectroscopy is a noninvasive optical technique that discriminates tissue by analyzing the absorption and reflection of light. This proof-of-concept study evaluated the potential of a diffuse reflectance spectroscopy probe as a quantitative additional tool for assessing laparoscopic skills.
Methods:
Surgical trainees were recruited at St. Mary's Hospital, Imperial College Healthcare NHS Trust, London (UK) and asked to scan 3 green targets using a diffuse reflectance spectroscopy probe in a laparoscopic phantom abdominal model. Optical spectra and video footage were recorded. Performance was scored using a simplified Global Operative Assessment of Laparoscopic Skills system across 3 domains: depth perception, bimanual dexterity, and efficiency (maximum total score: 15). Spectra were classified into "on target" (green), "off target" (phantom organ), and "idle" (noise). An on:off target ratio was computed and correlated with Global Operative Assessment of Laparoscopic Skills scores using linear regression.
Results:
A total of 21 participants were recruited, with 2,121 spectra recorded. The median on:off target ratio was 1.83 (interquartile range, 1.81) and the mean Global Operative Assessment of Laparoscopic Skills score was 10.9 (standard deviation, ±1.7). A significant positive correlation was found between on:off target ratio and Global Operative Assessment of Laparoscopic Skills (R2 = 0.37, P = .0072), suggesting higher technical performance aligned with greater probe targeting accuracy.
Conclusion:
Diffuse reflectance spectroscopy showed promise as a quantitative surgical training and assessment method, warranting further research into its utility as an adjunct to established scoring criteria to aid laparoscopic training.
