Graduate School of Engineering, Chiba University, Chiba, Japan.
Center for Frontier Medical Engineering, Chiba University, Chiba, Japan.
Int J Comput Assist Radiol Surg. 2019 Jan;14(1):93-104. doi: 10.1007/s11548-018-1855-y. Epub 2018 Sep 8.
This study proposes a method to analyze surgical performance by modeling, aligning, and comparing surgical processes. This method is intended to serve as a means to support the enhancement of surgical skills for endoscopic sinus surgeries (ESSs). We focus on surgical navigation systems used in image-guided ESSs and aim to construct a comparative analysis method for surgical processes based on the information about the surgical instruments motion obtained from the navigation system.
The proposed method consists of the following three parts: quantification of surgical features, modeling of surgical processes, and alignment and comparison of surgical process models (SPMs). First, we defined time-series parameters using the navigation-based surgical data. Second, we created SPMs by applying the defined parameters and the relative positional information of the instruments to the patient's anatomy. Third, we constructed a method to align and compare SPMs based on dynamic time warping with barycenter averaging.
The proposed method was validated on a dataset containing surgical data obtained by an optical tracking system from 14 clinical ESS cases. We evaluated the validity of the comparative analysis by aligning and comparing SPMs between experts and residents. The validation results suggested that the proposed method could achieve proper alignment of the SPMs and clarify the differences in surgical processes between experts and residents.
We developed a method to enable a time-series comparative analysis of surgical processes based on the surgical data from the navigation system. This method can allow surgeons to identify differences between their procedures and reference procedures such as experts' procedures.
本研究提出了一种通过建模、对齐和比较手术过程来分析手术表现的方法。该方法旨在支持内窥镜鼻窦手术（ESS）技能的提升。我们专注于图像引导 ESS 中使用的手术导航系统，并旨在构建一种基于导航系统获取的手术器械运动信息的手术过程比较分析方法。
所提出的方法包括以下三个部分：手术特征的量化、手术过程的建模以及手术过程模型（SPM）的对齐和比较。首先，我们使用基于导航的手术数据定义了时间序列参数。其次，我们通过将定义的参数和器械的相对位置信息应用于患者解剖结构来创建 SPM。最后，我们构建了一种基于动态时间规整和重心平均的 SPM 对齐和比较方法。
该方法在包含 14 例临床 ESS 手术的光学跟踪系统获得的手术数据的数据集上进行了验证。我们通过对齐和比较专家和住院医师之间的 SPM 来评估比较分析的有效性。验证结果表明，该方法可以实现 SPM 的适当对齐，并阐明专家和住院医师之间手术过程的差异。
我们开发了一种基于导航系统手术数据的手术过程时间序列比较分析方法。该方法可以让外科医生识别他们的手术过程与专家手术等参考手术之间的差异。
