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基于人工智能的腹腔镜胃远端切除术技能评估:一种新的仪器识别系统。

Laparoscopic distal gastrectomy skill evaluation from video: a new artificial intelligence-based instrument identification system.

机构信息

Department of Surgery, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University, Tochigi, Japan.

Medical Simulation Center, Jichi Medical University, Tochigi, Japan.

出版信息

Sci Rep. 2024 May 30;14(1):12432. doi: 10.1038/s41598-024-63388-y.

Abstract

The advent of Artificial Intelligence (AI)-based object detection technology has made identification of position coordinates of surgical instruments from videos possible. This study aimed to find kinematic differences by surgical skill level. An AI algorithm was developed to identify X and Y coordinates of surgical instrument tips accurately from video. Kinematic analysis including fluctuation analysis was performed on 18 laparoscopic distal gastrectomy videos from three expert and three novice surgeons (3 videos/surgeon, 11.6 h, 1,254,010 frames). Analysis showed the expert surgeon cohort moved more efficiently and regularly, with significantly less operation time and total travel distance. Instrument tip movement did not differ in velocity, acceleration, or jerk between skill levels. The evaluation index of fluctuation β was significantly higher in experts. ROC curve cutoff value at 1.4 determined sensitivity and specificity of 77.8% for experts and novices. Despite the small sample, this study suggests AI-based object detection with fluctuation analysis is promising because skill evaluation can be calculated in real time with potential for peri-operational evaluation.

摘要

基于人工智能(AI)的目标检测技术的出现使得从视频中识别手术器械的位置坐标成为可能。本研究旨在通过手术技能水平找到运动学差异。开发了一种 AI 算法,可从视频中准确识别手术器械尖端的 X 和 Y 坐标。对来自三位专家和三位新手外科医生的 18 个腹腔镜远端胃切除术视频进行了运动学分析,包括波动分析(3 个视频/外科医生,11.6 小时,1,254,010 帧)。分析表明,专家外科医生组的动作更高效且更有规律,手术时间和总行程明显更短。在技能水平之间,器械尖端的运动在速度、加速度或冲击方面没有差异。波动β的评估指标在专家中明显更高。在 1.4 时的 ROC 曲线截断值确定了专家和新手的敏感性和特异性分别为 77.8%。尽管样本较小,但本研究表明基于人工智能的对象检测与波动分析具有前景,因为可以实时计算技能评估,并且有可能在手术期间进行评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da20/11139867/81e6259fa228/41598_2024_63388_Fig1_HTML.jpg

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