title: Measurement of tremor transmission during microsurgery.
abstract: BACKGROUND
  Tremor is a major impediment to performing fine motor tasks, as in microsurgery. However, conventional measurements do not involve tasks representative of microsurgery.
  
  
  METHODS
  We developed a low-cost surgical simulator incorporating a force transducer capable of detecting and quantifying the effects of tremor upon high-fidelity silicone replicas of cardiac vessels and substrate muscle. Experienced and trainee surgeons performed simulated anastomoses on this rig. We characterized procedures in terms of tremor intensity, based on Lomb-Scargle periodograms.
  
  
  RESULTS
  Distinctive force oscillations occurred at 8-12 Hz, characteristic of enhanced physiological tremor, yielding peaks in power spectral density. These early results suggest a significantly lower transmission of tremor to the operative field by the experienced surgeon in comparison to the trainees.
  
  
  CONCLUSIONS
  This new device quantifies the action of tremor upon a manipulandum during a complex task, which may be used for assessment and providing feedback to trainee surgeons. Copyright © 2015 John Wiley & Sons, Ltd.
authors.affiliation: Faculty of Medicine and Health Sciences, Macquarie University, North Ryde, Australia.
authors.forename: David I
authors.initials: DI
authors.lastname: Verrelli
authors.affiliation: Faculty of Medicine and Health Sciences, Macquarie University, North Ryde, Australia.
authors.forename: Yi
authors.initials: Y
authors.lastname: Qian
authors.affiliation: Faculty of Medicine and Health Sciences, Macquarie University, North Ryde, Australia.
authors.forename: James
authors.initials: J
authors.lastname: Wood
authors.affiliation: Heart Care Centre, Macquarie University Hospital, North Ryde, Australia.|RPAH Medical Centre, Royal Prince Alfred Hospital, Camperdown, Australia.
authors.forename: Michael K
authors.initials: MK
authors.lastname: Wilson
mesh_terms: D000714:Anastomosis, Surgical; D001158:Arteries / Q000601:surgery; D006348:Cardiac Surgical Procedures; D002983:Clinical Competence; D003198:Computer Simulation; D013502:General Surgery / Q000193:education; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D009048:Motor Skills; D009132:Muscles / Q000601:surgery; D009991:Oscillometry; D012828:Silicones; D013314:Stress, Mechanical; D066231:Surgeons; D013647:Task Performance and Analysis; D014159:Transducers; D014202:Tremor
chemical_list: D012828:Silicones
keywords: anastomosis; assessment; fine motor skills; force transducer; frequency; microsurgery; surgical simulation; surgical skills; training; tremor