Synchronized video and motion analysis for the assessment of procedures in the operating theater.
OBJECTIVE
Objective assessment of surgical skill has recently been shown to be possible through the use of dexterity-based and video analysis systems. The aim of this study was to synchronize these 2 modalities to produce a comprehensive surgical assessment tool.


METHODS
The Imperial College Surgical Assessment Device is a dexterity-based motion analysis device that has been developed in the Department of Surgical Oncology and Technology by the Surgical Computing and Imaging Research Group. Further advances to this system have been made to enable synchronized acquisition of hand kinematics and video from real procedures, and their concurrent analysis. To test the feasibility of the system, 10 laparoscopic cholecystectomies performed by 5 different surgeons on consenting patients were recorded. Analysis focused on the entire procedure and also on specific parts of the operation such as the clipping and cutting of the cystic duct and artery.


RESULTS
Dexterity analysis was performed using the objective measures of time, path length, number of movements, velocities, and trajectories. Comparative analysis of a surgeon's dexterity was carried out on the whole procedure and by using the synchronized zoom facility in the software. Kinematic signals revealed rapid changes in velocity caused by alternating between different instruments or occurring after complications such as bleeding.


CONCLUSIONS
This new motion analysis system has been shown to be an effective tool for the comprehensive assessment of operative procedures.
Dosis
Aristotelis
A
Surgical Computing and Imaging Research Group, Department of Surgical Oncology and Technology, Imperial College London, 10th Floor Queen Mother Wing, St Mary's Hospital, London W2 1NY, United Kingdom. aristotelis.dosis@imperial.ac.uk
Aggarwal
Rajesh
R
Bello
Fernando
F
Moorthy
Krishna
K
Munz
Yaron
Y
Gillies
Duncan
D
Darzi
Ara
A
D017081:Cholecystectomy, Laparoscopic; D002983:Clinical Competence; D006801:Humans; D009068:Movement; D009873:Operating Rooms; D013514:Surgical Procedures, Operative; D013996:Time and Motion Studies; D014741:Video Recording