Feasibility of an AI-Based Measure of the Hand Motions of Expert and Novice Surgeons.

Munenori Uemura,Satoshi Ieiri,Morimasa Tomikawa,Makoto Hashizume,Tiejun Miao,Alan K Lefor,Ryota Souzaki,Tomohiko Akahoshi

doi:10.1155/2018/9873273

Munenori Uemura, Satoshi Ieiri + Show 6 more

Open Access

https://doi.org/10.1155/2018/9873273

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Abstract

This study investigated whether parameters derived from hand motions of expert and novice surgeons accurately and objectively reflect laparoscopic surgical skill levels using an artificial intelligence system consisting of a three-layer chaos neural network. Sixty-seven surgeons (23 experts and 44 novices) performed a laparoscopic skill assessment task while their hand motions were recorded using a magnetic tracking sensor. Eight parameters evaluated as measures of skill in a previous study were used as inputs to the neural network. Optimization of the neural network was achieved after seven trials with a training dataset of 38 surgeons, with a correct judgment ratio of 0.99. The neural network that prospectively worked with the remaining 29 surgeons had a correct judgment rate of 79% for distinguishing between expert and novice surgeons. In conclusion, our artificial intelligence system distinguished between expert and novice surgeons among surgeons with unknown skill levels.

Highlights

The relative importance of technical and nontechnical skills in surgical expertise is not well defined
In study 1, 11 of the participants were expert surgeons, each of whom had performed more than 500 laparoscopic operations and who had completed the skill assessment task, and 27 were inexperienced surgeons, each of whom had performed fewer than 15 laparoscopic operations and who had not completed the skill assessment task
There were no human interventions during classification, Mean squared error (MES)

Summary

Introduction

The relative importance of technical and nontechnical skills in surgical expertise is not well defined. The number of operations a surgeon has successfully performed is considered a valid indicator of surgical skill level; surgeons with more experience are considered “expert surgeons.”. From a nontechnical point of view, expert surgeons are expected to be able to determine methods of overcoming intraoperative difficulties and to manage these difficulties independently. Current methods of determining expertise based on years of experience tend to be subjective and not quantitative, and a valid definition of “expertise in laparoscopic surgery” is still under discussion [1]. The Japan Society for Endoscopic Surgery conducts the accreditation examination for laparoscopic surgery. Because the accreditation examination is a proven effective measure of clinical practice, judges’ evaluations are considered objective and are reproducible, to some extent [2]

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