| 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 |
| URI: | http://hdl.handle.net/2115/82346 |
| 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)
|
