Objective Assessment of Endovascular Navigation Skills with Force Sensing.
Despite the increasing popularity of endovascular intervention in clinical practice, there remains a lack of objective and quantitative metrics for skill evaluation of endovascular techniques. Data relating to the forces exerted during endovascular procedures and the behavioral patterns of endovascular clinicians is currently limited. This research proposes two platforms for measuring tool forces applied by operators and contact forces resulting from catheter-tissue interactions, as a means of providing accurate, objective metrics of operator skill within a realistic simulation environment. Operator manipulation patterns are compared across different experience levels performing various complex catheterization tasks, and different performance metrics relating to tool forces, catheter motion dynamics, and forces exerted on the vasculature are extracted. The results depict significant differences between the two experience groups in their force and motion patterns across different phases of the procedures, with support vector machine (SVM) classification showing cross-validation accuracies as high as 90% between the two skill levels. This is the first robust study, validated across a large pool of endovascular specialists, to present objective measures of endovascular skill based on exerted forces. The study also provides significant insights into the design of optimized metrics for improved training and performance assessment of catheterization tasks.
The Hamlyn Centre for Robotic Surgery, Imperial College London, Level 4, Bessemer Building, South Kensington Campus, London, SW7 2AZ, UK. h.rafii-tari11@imperial.ac.uk.
Hedyeh
0000-0002-5104-0649
H
Rafii-Tari
The Hamlyn Centre for Robotic Surgery, Imperial College London, Level 4, Bessemer Building, South Kensington Campus, London, SW7 2AZ, UK.
Christopher J
CJ
Payne
Academic Division of Surgery, Imperial College London, London, UK.
Colin
C
Bicknell
The Hamlyn Centre for Robotic Surgery, Imperial College London, Level 4, Bessemer Building, South Kensington Campus, London, SW7 2AZ, UK.|Department of Mechanical Engineering, The University of Hong Kong, Hong Kong, People's Republic of China.
Ka-Wai
KW
Kwok
Academic Division of Surgery, Imperial College London, London, UK.
Nicholas J W
NJW
Cheshire
Academic Division of Surgery, Imperial College London, London, UK.
Celia
C
Riga
The Hamlyn Centre for Robotic Surgery, Imperial College London, Level 4, Bessemer Building, South Kensington Campus, London, SW7 2AZ, UK.
Guang-Zhong
GZ
Yang
D002404:Catheterization; D002983:Clinical Competence; D057510:Endovascular Procedures; D006801:Humans; D008962:Models, Theoretical; D009038:Motion; D060388:Support Vector Machine
Catheter manipulation; Classification of skill; Endovascular intervention; Force sensing; Haptic and navigation cues; Robotic catheterization; Skill assessment