Harada Kanako, Morita Akio, Minakawa Yoshiaki, Baek Young Min, Sora Shigeo, Sugita Naohiko, Kimura Toshikazu, Tanikawa Rokuya, Ishikawa Tatsuya, Mitsuishi Mamoru
Department of Mechanical Engineering, The University of Tokyo, Tokyo, Japan.
Department of Neurological Surgery, Nippon Medical School, Tokyo, Japan.
World Neurosurg. 2015 Oct;84(4):964-71. doi: 10.1016/j.wneu.2015.05.033. Epub 2015 May 29.
Most methods currently used to assess surgical skill are rather subjective or not adequate for microneurosurgery. Objective and quantitative microneurosurgical skill assessment systems that are capable of accurate measurements are necessary for the further development of microneurosurgery.
Infrared optical motion tracking markers, an inertial measurement unit, and strain gauges were mounted on tweezers to measure many parameters related to instrument manipulation. We then recorded the activity of 23 neurosurgeons. The task completion time, tool path, and needle-gripping force were evaluated for three stitches made in an anastomosis of 0.7-mm artificial blood vessels. Videos of the activity were evaluated by three blinded expert surgeons.
Surgeons who had recently done many bypass procedures demonstrated better skills. These skilled surgeons performed the anastomosis with in a shorter time, with a shorter tool path, and with a lesser force when extracting the needle.
These results show the potential contribution of the system to microsurgical skill assessment. Quantitative and detailed analysis of surgical tasks helps surgeons better understand the key features of the required skills.
目前用于评估手术技能的大多数方法相当主观，或者不适用于显微神经外科手术。对于显微神经外科手术的进一步发展而言，具备精确测量能力的客观且定量的显微神经外科手术技能评估系统是必要的。
将红外光学运动跟踪标记、惯性测量单元和应变仪安装在镊子上，以测量与器械操作相关的许多参数。然后我们记录了23位神经外科医生的操作活动。对在0.7毫米人造血管吻合术中进行的三针缝合的任务完成时间、工具路径和持针力进行了评估。活动视频由三位不知情的专家外科医生进行评估。
近期进行了许多搭桥手术的外科医生表现出更好的技能。这些熟练的外科医生在进行吻合术时用时更短、工具路径更短，并且在拔针时用力更小。
这些结果显示了该系统对显微手术技能评估的潜在贡献。对外科手术任务进行定量和详细分析有助于外科医生更好地理解所需技能的关键特征。
