CARD30: Variability of Operator’s Physiologic and Motion Patterns in the Surgical Environment

Abstract

Introduction: During a cardiac surgery, continuous interaction occurs between the surgeon and the environment. We analyzed these interactions and their correlation with surgical stages. Methods: Recorded data included a volunteer surgeon’s physiologic data: heart rate (HR), O2 saturation (SAT), and physical data included environmental noise level in decibel (dB), hand motions quaternion data for navigation of hands in 3D space during the surgery. Results: During the surgery, surgeon’s mean HR was 71/min (62-92), the mean SAT was 98.7% (96-99%) and the mean noise level was 67 dB (61-84). The quaternion data showed a rotation angle of the surgeon’s arm in 3D space from 40-180 degrees, (Figure 1). The highest HR was recorded just prior to removal of the aortic cross-clamp until coming off cardiopulmonary bypass. A single drop in SAT to 96% was recorded during the chest opening, correlating with electrocautery use. The average noise level was 67 dB, comparable to a vacuum cleaner noise, about 20dB louder than a typical office noise level. Some noise peaks were followed by HR increase. The longest low-noise period was during the cardiopulmonary bypass when most alarms were off. Hands motion analysis showed that there are certain periods of the operation with sharp changes in the orientation angle corresponding to various surgical stages. The slight variations refer to microsurgery when the arm is almost static, and fingers and/or wrist do the necessary rotations and the wider motions represent actions such as chest closure. Conclusion: This study represents the complex interactions between human and the surroundings during a surgery. The inputs from various sources have the potential to affect surgeon’s physiologic state and are recognizable as a pattern which could be easily studied for prediction of surgical conduct in tools such as artificial intelligence, or for design and improvement of future surgical technologies to improve patient outcome.Figure 1. Data Recorded During the Surgery, (Horizontal axis represents the surgical time)