A marker-less technique for measuring kinematics in the operating room

Lane L. Frasier, David P. Azari, Yue Ma, Sudha R. Pavuluri Quamme, Robert G. Radwin, Carla M. Pugh, Thomas Y. Yen, Chia-Hsiung Chen, Caprice C. Greenberg
2016 Surgery  
Background-Quantitative analysis of technical skill relies largely on specially-tagged instruments or tracers on surgeons' hands, often in simulated settings. We investigated a novel, marker-less technique for evaluating technical skill during open surgeries, and differentiating tasks and surgeon experience level. Methods-We recorded the operative field via in-light camera for open operations. Sixteen cases yielded 138 video clips of suturing and tying tasks ≥5 seconds in length. Video clips
more » ... e categorized based on surgeon role (attending, resident) and task sub-type (suturing tasks: Body Wall, Bowel Anastomosis, Complex Anastomosis; tying tasks: Body Wall, Superficial Tying; Deep Tying). We tracked a region of interest on the hand to generate kinematic data. Nested multilevel modeling addressed the non-independence of clips obtained from the same surgeon. Results-Interaction effects for suturing tasks were seen between role and task categories for average speed (p=0.04), standard deviation of speed (p=0.05), and average acceleration (p=0.03). There were significant differences across task categories for standard deviation of acceleration (p=0.02). Significant differences for tying tasks across task categories were observed for maximum speed (p=0.02), standard deviation of speed (0.04), and average (p=0.02), maximum (p<0.01), and standard deviation (p=0.03) of acceleration. Conclusions-We demonstrated the ability to detect kinematic differences in performance using marker-less tracking during open surgical cases. Suturing task evaluation was most sensitive to differences in surgeon role and task category and may represent a scalable approach to provide quantitative feedback to surgeons about technical skill. Frasier et al.
doi:10.1016/j.surg.2016.05.004 pmid:27342198 pmcid:PMC5086277 fatcat:iyc4corya5ecdpgtmljb4tdqaa