Evaluating surgical dexterity during corneal suturing.
OBJECTIVE
To evaluate motion tracking as an aid to a more objective assessment of ophthalmic microsurgical skill.


METHODS
In a cohort study, 3 groups of differing levels of surgical experience were assessed. The groups included novice surgeons (n = 10) with fewer than 5 previously performed corneal sutures, trainee surgeons (n = 10) with 5 to 100 previously performed corneal sutures, and expert surgeons (n = 10) with more than 100 previously performed corneal sutures. The Imperial College Surgical Assessment Device was used for the objective assessment of surgical dexterity during corneal suturing. Each of the subjects used a 10-0 nylon suture in a 3-1-1 pattern on an artificial eye (Royal College of Ophthalmologists, London, England). The Imperial College Surgical Assessment Device measures 3-dimensional spatial vectors via electromagnetic sensors attached to the surgeon's fingers. The number of movements, path length for the respective movements, and time taken to complete the given task were recorded.


RESULTS
Highly statistically significant differences were found between the 3 grades of surgeon experience for time taken (P<.001), number of hand movements (P<.001), and path length of the hand movements (P = .002) to complete the given task.


CONCLUSIONS
Motion analysis measured by this technology may be useful in the formal surgical training of residents and as an objective quantitative measure of dexterity.
Saleh
George M
GM
Department of Ophthalmology, Royal Surrey County Hospital, Egerton Road, Guildford GU2 7XX, Surrey, England. drgmsaleh@yahoo.co.uk
Voyatzis
George
G
Voyazis
Yiorgos
Y
Hance
Julian
J
Ratnasothy
Joel
J
Darzi
Ara
A
D002983:Clinical Competence; D016039:Corneal Transplantation; D006801:Humans; D007396:Internship and Residency; D008866:Microsurgery / Q000193:education; D009048:Motor Skills / Q000502:physiology*; D009068:Movement / Q000502:physiology*; D009885:Ophthalmology / Q000193:education*; D013536:Suture Techniques; D013647:Task Performance and Analysis