Artificial Intelligence-Based Video Feedback to Improve Novice Performance on Robotic Suturing Skills: A Pilot Study

Abstract

<b><i>Introduction:</i></b> Automated skills assessment can provide surgical trainees with objective, personalized feedback during training. Here, we measure the efficacy of artificial intelligence (AI)-based feedback on a robotic suturing task. <b><i>Materials and Methods:</i></b> Forty-two participants with no robotic surgical experience were randomized to a control or feedback group and video-recorded while completing two rounds (R1 and R2) of suturing tasks on a da Vinci surgical robot. Participants were assessed on needle handling and needle driving, and feedback was provided via a visual interface after R1. For feedback group, participants were informed of their AI-based skill assessment and presented with specific video clips from R1. For control group, participants were presented with randomly selected video clips from R1 as a placebo. Participants from each group were further labeled as underperformers or innate-performers based on a median split of their technical skill scores from R1. <b><i>Results:</i></b> Demographic features were similar between the control (<i>n</i> = 20) and feedback group (<i>n</i> = 22) (<i>p</i> > 0.05). Observing the improvement from R1 to R2, the feedback group had a significantly larger improvement in needle handling score (0.30 <i>vs</i> -0.02, <i>p</i> = 0.018) when compared with the control group, although the improvement of needle driving score was not significant when compared with the control group (0.17 <i>vs</i> -0.40, <i>p</i> = 0.074). All innate-performers exhibited similar improvements across rounds, regardless of feedback (<i>p</i> > 0.05). In contrast, underperformers in the feedback group improved more than the control group in needle handling (<i>p</i> = 0.02). <b><i>Conclusion:</i></b> AI-based feedback facilitates surgical trainees' acquisition of robotic technical skills, especially underperformers. Future research will extend AI-based feedback to additional suturing skills, surgical tasks, and experience groups.