Haptic feedback can provide an objective assessment of arthroscopic skills.
The outcome of arthroscopic procedures is related to the surgeon's skills in arthroscopy. Currently, evaluation of such skills relies on direct observation by a surgeon trainer. This type of assessment, by its nature, is subjective and time-consuming. The aim of our study was to identify whether haptic information generated from arthroscopic tools could distinguish between skilled and less skilled surgeons. A standard arthroscopic probe was fitted with a force/torque sensor. The probe was used by five surgeons with different levels of experience in knee arthroscopy performing 11 different tasks in 10 standard knee arthroscopies. The force/torque data from the hand and tool interface were recorded and synchronized with a video recording of the procedure. The torque magnitude and patterns generated were analyzed and compared. A computerized system was used to analyze the force/torque signature based on general principles for quality of performance using such measures as economy in movement, time efficiency, and consistency in performance. The results showed a considerable correlation between three haptic parameters and the surgeon's experience, which could be used in an automated objective assessment system for arthroscopic surgery.


METHODS
Level II, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.
Chami
George
G
Department of Computer Science, University of Hull, Hull, UK. georgechami@doctors.org.uk
Ward
James W
JW
Phillips
Roger
R
Sherman
Kevin P
KP
D020679:Arthroscopes; D001182:Arthroscopy / Q000592:standards*; D002983:Clinical Competence; D003194:Computer-Assisted Instruction; D004867:Equipment Design; D030141:Feedback, Psychological; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D009048:Motor Skills; D011787:Quality of Health Care; D012815:Signal Processing, Computer-Assisted; D013647:Task Performance and Analysis; D013997:Time Factors; D019415:Torque; D014584:User-Computer Interface