Synchronized Video and Motion Analysis for the Assessment of Procedures in the Operating Theater

TLDR

Objective assessment of surgical skill can be achieved using dexterity‑based and video analysis systems. The study aimed to synchronize dexterity‑based motion analysis with video to create a comprehensive surgical assessment tool. The system synchronizes hand kinematics and video during real laparoscopic cholecystectomies, recording 10 procedures by 5 surgeons and analyzing overall and step‑specific dexterity metrics such as time, path length, movements, velocities, and trajectories. Kinematic data showed rapid velocity changes during instrument switches and complications, demonstrating the system’s effectiveness for comprehensive operative assessment.

Abstract

Objective assessment of surgical skill has recently been shown to be possible through the use of dexterity-based and video analysis systems. The aim of this study was to synchronize these 2 modalities to produce a comprehensive surgical assessment tool.The Imperial College Surgical Assessment Device is a dexterity-based motion analysis device that has been developed in the Department of Surgical Oncology and Technology by the Surgical Computing and Imaging Research Group. Further advances to this system have been made to enable synchronized acquisition of hand kinematics and video from real procedures, and their concurrent analysis. To test the feasibility of the system, 10 laparoscopic cholecystectomies performed by 5 different surgeons on consenting patients were recorded. Analysis focused on the entire procedure and also on specific parts of the operation such as the clipping and cutting of the cystic duct and artery.Dexterity analysis was performed using the objective measures of time, path length, number of movements, velocities, and trajectories. Comparative analysis of a surgeon's dexterity was carried out on the whole procedure and by using the synchronized zoom facility in the software. Kinematic signals revealed rapid changes in velocity caused by alternating between different instruments or occurring after complications such as bleeding.This new motion analysis system has been shown to be an effective tool for the comprehensive assessment of operative procedures.