SP2.1.1Continuous Monitoring and Assessment of Surgical Technical Skills Using Deep Learning

Abstract

Abstract Aims Excellent surgical technical skills are of paramount importance to perform surgical procedures, safely and efficiently. Virtual reality surgical simulators can both simulate real operations while providing standardized, risk-free surgical hands-on experience. The integration of AI (artificial intelligence) and virtual reality simulators provides opportunities to carry out comprehensive continuous assessments of surgical performance. We developed and tested a deep learning algorithm which can continuously monitor and assess surgical bimanual performance on virtual reality surgical simulators. Methods Fifty participants from four expertise levels (14 experts/neurosurgeons, 14 senior residents, 10 junior residents, 12 medical students) performed a simulated subpial tumor resection 5 times and a complex simulated brain tumor operation once on the NeuroVR platform. Participants were asked to remove the tumors completely while minimizing bleeding and damage to surrounding tissues employing a simulated ultrasonic aspirator and bipolar forceps. A deep neural network continually tracked the surgical performance utilizing 16 performance metrics generated every 0.2-seconds. Results The deep neural network was successfully trained using neurosurgeons and medical students’ data, learning the composites of expertise comparing high and lower skill levels. The trained algorithm was able to score the technical skills of individuals continuously at 0.2-second intervals. Statistically significant differences in average scores were identified between the 4 groups. Conclusions AI-powered surgical simulators provide continuous assessment of bimanual technical skills during surgery which may further define the composites necessary to train surgical expertise. To our knowledge, this is the first attempt in surgery to continuously assess surgical technical skills using deep learning.