Psychomotor skills assessment by motion analysis in minimally invasive surgery on an animal organ

Abstract

Background: A high level of psychomotor skills is required to perform minimally invasive surgery (MIS) safely. To be able to measure these skills is important in the assessment of surgeons, as it enables constructive feedback during training. The aim of this study was to test the validity of an objective and automatic assessment method using motion analysis during a laparoscopic procedure on an animal organ.

Material and methods: Experienced surgeons in laparoscopy (experts) and medical students (novices) performed a cholecystectomy on a porcine liver box model. The motions of the surgical tools were acquired and analyzed by 11 different motion-related metrics, i.e., a total of 19 metrics as eight of them were measured separately for each hand. We identified for which of the metrics the experts outperformed the novices.

Results: In total, two experts and 28 novices were included. The experts achieved significantly better results for 13 of the 19 instrument motion metrics.

Conclusions: Expert performance is characterized by a low time to complete the cholecystectomy, high bimanual dexterity (instrument coordination), a limited amount of movement and low measurement of motion smoothness of the dissection instrument, and relatively high usage of the grasper to optimize tissue positioning for dissection.

Keywords:

• Minimally invasive surgery
• surgical skills assessment
• motion analysis
• psychomotor skills
• video-box trainer

Acknowledgements

We thank all those who participated in the study, in addition to Kirsten Rønning for help with preparing the box models. The work has been supported by the Central Norway Regional Health Authority, SINTEF Technology and Society, the Norwegian University of Science and Technology (NTNU), the National Advisory Board for Advanced Laparoscopic Surgery and the National Advisory Board for Ultrasound and Image-Guided Therapy (all Trondheim, Norway).

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Additional information

Funding

The work has been supported by the Central Norway Regional Health Authority, SINTEF Technology and Society, the Norwegian University of Science and Technology (NTNU), the National Advisory Board for Advanced Laparoscopic Surgery and the National Advisory Board for Ultrasound and Image-Guided Therapy (all Trondheim, Norway).