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News

Expert vs nonexpert performance in minimally invasive surgery

A study in this month's issue of Surgical Endoscopy investigates psychomotor skills in minimally invasive surgery.

News image

A high level of psychomotor skills is required to perform minimally invasive surgery safely.

To assure high quality of skills, it is important to be able to measure and assess these skills.

Dr Erlend Fagertun Hofstad and colleagues determined aspects that indicate the difference between performances at various levels of proficiency.

Measurement and assessment of skills in minimally invasive surgery are best done in an automatic and objective way.

The research team assessed that the goal of this study was to investigate a set of 9 motion-related metrics for their relevance to assess psychomotor skills in minimally invasive surgery during the performance of a labyrinth task.

The team divided 32 surgeons and medical students into 3 groups according to their level of experience in minimally invasive surgery, including those that were experts, intermediates, and novices.

The participants performed the labyrinth task in the D-box Basic simulator.

The researchers reported that he task required bimanual maneuvering and threading a needle through a labyrinth of 10 holes.

9 motion-related metrics were used to assess minimally invasive surgery skills
Surgical Endoscopy

The team used 9 motion-related metrics to assess the minimally invasive surgery skills of each participant.

The team of doctors noted that experts and intermediates performed significantly better than the novices in terms of time and parameters measuring the amount of instrument movement.

The experts had significantly better bimanual dexterity, which indicated that they made more simultaneous movements of the 2 instruments compared to the intermediates and novices.

The research team reported that the experts also performed the task with a shorter instrument path length with the nondominant hand than the intermediates.

Dr Hofstad's team concludes, "The surgeon’s performance in minimally invasive surgery can be distinguished from a novice by metrics such as time and path length."

"An experienced surgeon in minimally invasive surgery can be differentiated from a less experienced one by the higher ability to control the instrument in the nondominant hand and the higher degree of simultaneous (coordinated) movements of the 2 instruments."

Surgical Endoscopy 2013: 27(3): 854-863
29 March 2013

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