Western University of Health Sciences, College of Osteopathic Medicine, Lebanon, Oregon.
The Arkansas College of Osteopathic Medicine, Fort Smith, Arkansas.
J Surg Res. 2024 Apr;296:411-417. doi: 10.1016/j.jss.2023.12.053. Epub 2024 Feb 3.
Surgical experience is often reflected by efficient, fluid, and well-calculated movements. For a new trainee, learning these characteristics is possible only by observation as there is no quantification system to define these factors. We analyzed surgeons' hand movements with different experience levels to characterize their movements according to experience.
Hand motions were recorded by an inertial measurement unit (IMU) mounted on the hands of the surgeons during a simulated surgical procedure. IMU data provided acceleration and Eulerian angles: yaw, roll, and pitch corresponding to hand motions as radial/ulnar deviation, pronation/supination, and extension/flexion, respectively. These variables were graphically depicted and compared between three surgeons.
Participants were assigned to three groups based on years of surgical experience: group 1: >15 y; group 2: 3-10 y; and group 3: 0-1 y. Visualization of the roll motion, being the main motion during suturing, showed the clear difference in fluidity and regularity of the movements between the groups, showing minimal wasted movements for group 1. The angle of the roll motion, measured at the minimum, midpoint, and maximum points was significantly different between the groups. As expected, the experienced group completed the procedure first; however, the acceleration was not different between the groups.
Surgeons' hand movements can be easily characterized and quantified by an IMU device for automatic assessment of surgical skills. These characteristics graphically visualize a surgeon's regularity, fluidity, economy, and efficiency. The characteristics of an experienced surgeon can serve as a training model and as a reference tool for trainees.
手术经验通常反映在高效、流畅和精心计算的动作中。对于新手而言，只能通过观察来学习这些特征，因为目前还没有量化系统来定义这些因素。我们分析了不同经验水平的外科医生的手部动作，根据经验对他们的动作进行了特征描述。
通过惯性测量单元（IMU）在手外科医生模拟手术过程中记录手部运动。IMU 数据提供了加速度和欧拉角：绕着手术医生的手部的偏航、滚转和俯仰角，分别对应于手部的桡侧/尺侧偏移、旋前/旋后和伸展/屈曲运动。这些变量以图形方式呈现，并在三名外科医生之间进行了比较。
参与者根据手术经验年限被分为三组：第 1 组：>15 年；第 2 组：3-10 年；第 3 组：0-1 年。在缝合过程中的主要运动——滚转运动的可视化显示了不同组之间动作流畅性和规律性的明显差异，第 1 组显示出最小的浪费动作。在滚转运动的最小、中点和最大角度处测量的角度在组间有显著差异。不出所料，经验丰富的组首先完成了手术；然而，组间的加速度没有差异。
通过 IMU 设备可以轻松地对手部运动进行特征描述和量化，从而自动评估手术技能。这些特征直观地展示了外科医生的规律性、流畅性、经济性和效率。有经验的外科医生的特征可以作为培训模型和参考工具供学员使用。
