Comparison of a supplemental wide field of view versus a single field of view with zoom on performance in minimally invasive surgery.

BACKGROUND: The limited space and high magnification involved in minimally invasive surgery (MIS) can cause surgeons to lose sight of an instrument while performing tasks such as suturing and knot-tying. A current strategy employed to locate the instrument is zooming out and in with the endoscope, which can be a time-intensive and iterative task. This study investigates the use of a supplemental wide field of view (FOV) via a second endoscope for locating an instrument outside the FOV in a MIS setting. METHODS: Ten surgically naïve subjects performed a simple aimed movement task with either hand (dominant or nondominant) under two display conditions: (1) conventional single monitor with zoom, and (2) supplemental wide FOV monitor with no zoom. The task emulated the need to locate an instrument outside the surgeon's FOV and return it to a home position. RESULTS: The supplemental wide FOV produced significantly faster times [F(3,716) = 173.2, p < 0.001)] compared to a single monitor. The task was accomplished most quickly with the dual monitor with the dominant hand, followed by dual monitor with nondominant hand followed by a single monitor with either hand. There were also significantly fewer errors (t = 3.734, df = 9, p = 0.005) with the supplemental wide FOV. None of the subjects were slower with the dual monitor, and all but one had fewer errors. The variance for both task times and errors were also significantly smaller (p < 0.001 and p = 0.008, respectively) with the supplemental wide FOV indicating that subjects performed with increased reliability. CONCLUSION: The supplemental wide FOV gave the subjects the ability to see their instrument at all times providing a more efficient display than zooming out and in. This enabled faster times and fewer errors while allowing the user to perform the task with more consistency.

Automated robot-assisted surgical skill evaluation: Predictive analytics approach.

BACKGROUND: Surgical skill assessment has predominantly been a subjective task. Recently, technological advances such as robot-assisted surgery have created great opportunities for objective surgical evaluation. In this paper, we introduce a predictive framework for objective skill assessment based on movement trajectory data. Our aim is to build a classification framework to automatically evaluate the performance of surgeons with different levels of expertise. METHODS: Eight global movement features are extracted from movement trajectory data captured by a da Vinci robot for surgeons with two levels of expertise - novice and expert. Three classification methods - k-nearest neighbours, logistic regression and support vector machines - are applied. RESULTS: The result shows that the proposed framework can classify surgeons' expertise as novice or expert with an accuracy of 82.3% for knot tying and 89.9% for a suturing task. CONCLUSION: This study demonstrates and evaluates the ability of machine learning methods to automatically classify expert and novice surgeons using global movement features.

Supplemental wide field-of-view monitor improves performance in surgical telerobotic movement time.

BACKGROUND: This study investigates the effect of a supplemental wide field-of-view (FOV) monitor on performance at high magnifications where the benefits of robotic surgery have greater importance. METHODS: Ten surgically naïve participants performed a simple aimed movement task under two different monitor conditions. The task is intended to emulate the need to locate an instrument outside the surgeon's FOV and return it to a 'home' position without the need to zoom. One monitor condition used a narrow FOV (25x) coupled with a supplemental wide FOV (3x). The second monitor condition used only a narrow FOV. RESULTS: Using a supplemental wide FOV in addition to a narrow FOV improved task performance by at least 33%, with greater consistency and reliability. CONCLUSION: The supplemental wide FOV monitor provided additional information to the participant, allowing more efficient performance at high magnifications without the need for zooming.