title: Surgical task analysis of simulated laparoscopic cholecystectomy with a navigation system.
abstract: OBJECTIVE
  Advanced surgical procedures, which have become complex and difficult, increase the burden of surgeons. Quantitative analysis of surgical procedures can improve training, reduce variability, and enable optimization of surgical procedures. To this end, a surgical task analysis system was developed that uses only surgical navigation information.
  
  
  METHODS
  Division of the surgical procedure, task progress analysis, and task efficiency analysis were done. First, the procedure was divided into five stages. Second, the operating time and progress rate were recorded to document task progress during specific stages, including the dissecting task. Third, the speed of the surgical instrument motion (mean velocity and acceleration), as well as the size and overlap ratio of the approximate ellipse of the location log data distribution, was computed to estimate the task efficiency during each stage. These analysis methods were evaluated based on experimental validation with two groups of surgeons, i.e., skilled and "other" surgeons. The performance metrics and analytical parameters included incidents during the operation, the surgical environment, and the surgeon's skills or habits.
  
  
  RESULTS
  Comparison of groups revealed that skilled surgeons tended to perform the procedure in less time and involved smaller regions; they also manipulated the surgical instruments more gently.
  
  
  CONCLUSIONS
  Surgical task analysis developed for quantitative assessment of surgical procedures and surgical performance may provide practical methods and metrics for objective evaluation of surgical expertise.
authors.affiliation: Department of Medical System Engineering, Graduate School of Engineering, Chiba University, 1-33 Yayoi-cho, Inage-ku, Chiba, 263-8522, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Sugino
authors.forename: H
authors.initials: H
authors.lastname: Kawahira
authors.forename: R
authors.initials: R
authors.lastname: Nakamura
mesh_terms: D017081:Cholecystectomy, Laparoscopic / Q000193:education* / Q000379:methods; D002983:Clinical Competence; D003198:Computer Simulation; D004502:Education, Medical, Continuing / Q000379:methods*; D004521:Educational Measurement / Q000379:methods*; D004867:Equipment Design; D006801:Humans; D025321:Surgery, Computer-Assisted / Q000193:education* / Q000295:instrumentation*; D014057:Tomography, X-Ray Computed