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Motion analysis for better understanding of psychomotor skills in laparoscopy : objective assessment-based simulation training using animal organs

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Title: Motion analysis for better understanding of psychomotor skills in laparoscopy : objective assessment-based simulation training using animal organs
Authors: Ebina, Koki Browse this author
Abe, Takashige Browse this author →KAKEN DB
Higuchi, Madoka Browse this author
Furumido, Jun Browse this author
Iwahara, Naoya Browse this author
Kon, Masafumi Browse this author →KAKEN DB
Hotta, Kiyohiko Browse this author →KAKEN DB
Komizunai, Shunsuke Browse this author →KAKEN DB
Kurashima, Yo Browse this author →KAKEN DB
Kikuchi, Hiroshi Browse this author →KAKEN DB
Matsumoto, Ryuji Browse this author →KAKEN DB
Osawa, Takahiro Browse this author →KAKEN DB
Murai, Sachiyo Browse this author
Tsujita, Teppei Browse this author
Sase, Kazuya Browse this author
Chen, Xiaoshuai Browse this author
Konno, Atsushi Browse this author →KAKEN DB
Shinohara, Nobuo Browse this author →KAKEN DB
Keywords: Laparoscopic surgery
Simulation training
Motion capture
Surgical education
Issue Date: Aug-2021
Publisher: Springer
Journal Title: Surgical endoscopy and other interventional techniques
Volume: 35
Start Page: 4399
End Page: 4416
Publisher DOI: 10.1007/s00464-020-07940-7
Abstract: Background Our aim was to characterize the motions of multiple laparoscopic surgical instruments among participants with different levels of surgical experience in a series of wet-lab training drills, in which participants need to perform a range of surgical procedures including grasping tissue, tissue traction and dissection, applying a Hem-o-lok clip, and suturing/knotting, and digitize the level of surgical competency. Methods Participants performed tissue dissection around the aorta, dividing encountered vessels after applying a Hem-o-lok (Task 1), and renal parenchymal closure (Task 2: suturing, Task 3: suturing and knot-tying), using swine cadaveric organs placed in a box trainer under a motion capture (Mocap) system. Motion-related metrics were compared according to participants' level of surgical experience (experts: 50 <= laparoscopic surgeries, intermediates: 10-49, novices: 0-9), using the Kruskal-Wallis test, and significant metrics were subjected to principal component analysis (PCA). Results A total of 15 experts, 12 intermediates, and 18 novices participated in the training. In Task 1, a shorter path length and faster velocity/acceleration/jerk were observed using both scissors and a Hem-o-lok applier in the experts, and Hem-o-lok-related metrics markedly contributed to the 1st principal component on PCA analysis, followed by scissors-related metrics. Higher-level skills including a shorter path length and faster velocity were observed in both hands of the experts also in tasks 2 and 3. Sub-analysis showed that, in experts with 100 <= cases, scissors moved more frequently in the "close zone (0 <= to < 2.0 cm from aorta)" than those with 50-99 cases. Conclusion Our novel Mocap system recognized significant differences in several metrics in multiple instruments according to the level of surgical experience. "Applying a Hem-o-lok clip on a pedicle" strongly reflected the level of surgical experience, and zone-metrics may be a promising tool to assess surgical expertise. Our next challenge is to give completely objective feedback to trainees on-site in the wet-lab.
Type: article
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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