Laparoscopic Surgery

Background 

Performing laparoscopic surgery requires several skills, which have never been required for conventional open surgery. Surgeons experience difficulties in learning and mastering these techniques. Various training methods and metrics have been developed to assess and improve surgeon’s operative abilities. While these training metrics are currently widely being used, skill evaluation methods are still far from being objective in the regular laparoscopic skill education.

Objective 

Our aim is to define a set of parameters that allow us to characterize surgeon's movements during a surgical procedure, in order to see how surgeons of different expertise rank act during the operation in relation to these movement parameters, and to evaluate the improvement of performance after training. These analyses and modeling, in turn, represent a significant step towards the automatization and the robotic assistance for surgery.

Results 

The preliminary analysis of the data acquired during the experiments (the mean and standard deviation of acceleration; 95% cumulated distribution of acceleration; the path length of the movements of hands and the execution time completing the knots) clearly shows the novice’s improvements after the training. Moreover, the overall results are in line with the ones obtained with other - more expensive and more cumbersome - systems, thus confirming the validity of the proposed approach. The results presented in this paper are a clear step towards the development of a training system for an objective evaluation of the surgeon’s performance in particular during MIS. These results could also be extended to develop instruments and methodologies for a functional/ergonomic evaluation of surgical instruments.

 Relevant publications

  • Z. Lin, M. Uemura, M. Zecca, S. Sessa, H. Ishii, M. Tomikawa, M. Hashizume, and A. Takanishi, “Objective Skill Evaluation for Laparoscopic Training Based on Motion Analysis,” IEEE Transactions on Biomedical Engineering, vol. 60, no. 4, pp. 977–985, 2013. [2.15 Impact Factor]  [PDF
  • Z. Lin, M. Zecca  S. Sessa, T. Kusano, K. Itoh, and A. Takanishi,, Waseda Bioinstrumentation System WB-2R as a Wearable Tool for an Objective Analysis of Surgeon's Performance, in IEEE/ASME International Conference on Advanced Intelligent Machatronics AIM2009, Singapore, 2009, pp. 705-710.

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