Analysis of the Structure of Surgical Activity for a Suturing and Knot-Tying Task

作者:Vedula S Swaroop*; Malpani Anand O; Tao Lingling; Chen George; Gao Yixin; Poddar Piyush; Ahmidi Narges; Paxton Christopher; Vidal Rene; Khudanpur Sanjeev; Hager Gregory D; Chen Chi Chiung Grace
来源:PLos One, 2016, 11(3): e0149174.
DOI:10.1371/journal.pone.0149174

摘要

Background Surgical tasks are performed in a sequence of steps, and technical skill evaluation includes assessing task flow efficiency. Our objective was to describe differences in task flow for expert and novice surgeons for a basic surgical task. Methods We used a hierarchical semantic vocabulary to decompose and annotate maneuvers and gestures for 135 instances of a surgeon's knot performed by 18 surgeons. We compared counts of maneuvers and gestures, and analyzed task flow by skill level. Results Experts used fewer gestures to perform the task (26.29; 95% CI = 25.21 to 27.38 for experts vs. 31.30; 95% CI = 29.05 to 33.55 for novices) and made fewer errors in gestures than novices (1.00; 95% CI = 0.61 to 1.39 vs. 2.84; 95% CI = 2.3 to 3.37). Transitions among maneuvers, and among gestures within each maneuver for expert trials were more predictable than novice trials. Conclusions Activity segments and state flow transitions within a basic surgical task differ by surgical skill level, and can be used to provide targeted feedback to surgical trainees.

  • 出版日期2016-3-7