title: Surgical Hand Tracking in Open Surgery Using a Versatile Motion Sensing System: Are We There Yet?
abstract: With changes in work hour limitations, there is an increasing need for objective determination of technical proficiency. Electromagnetic hand-motion analysis has previously shown only time to completion and number of movements to correlation with expertise. The present study was undertaken to evaluate the efficacy of hand-motion-tracking analysis in determining surgical skill proficiency. A nine-degree-of-freedom sensor was used and mounted on the superior aspect of a needle driver. A one-way analysis of variance and Welch's t test were performed to evaluate significance between subjects. Four Novices, four Trainees, and three Experts performed a large vessel patch anastomosis on a phantom tissue. Path length, total number of movements, absolute velocity, and total time were analyzed between groups. Compared to the Novices, Expert subjects exhibited significantly decreased total number of movements, decreased instrument path length, and decreased total time to complete tasks. There were no significant differences found in absolute velocity between groups. In this pilot study, we have identified significant differences in patterns of motion between Novice and Expert subjects. These data warrant further analysis for its predictive value in larger cohorts at different levels of training and may be a useful tool in competence-based training paradigms in the future.
authors: Division of Cardiac Surgery and †Center for Advanced Surgical and Interventional Technology, University of California at Los Angeles, Los Angeles, California, USA.
authors: Bradley
authors: B
authors: Genovese
authors: Steven
authors: S
authors: Yin
authors: Sohail
authors: S
authors: Sareh
authors: Michael
authors: M
authors: DeVirgilio
authors: Laith
authors: L
authors: Mukdad
authors: Jessica
authors: J
authors: Davis
authors: Veronica J
authors: VJ
authors: Santos
authors: Peyman
authors: P
authors: Benharash
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D002983:Clinical Competence; D013502:General Surgery / Q000379:methods; D006225:Hand / Q000502:physiology*; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data; D008505:Medical Staff, Hospital / Q000706:statistics & numerical data; D009038:Motion; D009048:Motor Skills / Q000502:physiology*; D012494:Sampling Studies; D013337:Students, Medical / Q000706:statistics & numerical data; D013647:Task Performance and Analysis