Utilizing a multilayer perceptron artificial neural network to assess a virtual reality surgical procedure.

Abstract

Virtual reality surgical simulators are a safe and efficient technology for the assessment and training of surgical skills. Simulators allow trainees to improve specific surgical techniques in risk-free environments. Recently, machine learning has been coupled to simulators to classify performance. However, most studies fail to extract meaningful observations behind the classifications and the impact of specific surgical metrics on the performance. One benefit from integrating machine learning algorithms, such as Artificial Neural Networks, to simulators is the ability to extract novel insights into the composites of the surgical performance that differentiate levels of expertise. This study aims to demonstrate the benefits of artificial neural network algorithms in assessing and analyzing virtual surgical performances. This study applies the algorithm on a virtual reality simulated annulus incision task during an anterior cervical discectomy and fusion scenario. An artificial neural network algorithm was developed and integrated. Participants performed the simulated surgical procedure on the Sim-Ortho simulator. Data extracted from the annulus incision task were extracted to generate 157 surgical performance metrics that spanned three categories (motion, safety, and efficiency). Musculoskeletal Biomechanics Research Lab; Neurosurgical Simulation and Artificial Intelligence Learning Center, McGill University, Montreal, Canada. Twenty-three participants were recruited and divided into 3 groups: 11 post-residents, 5 senior and 7 junior residents. An artificial neural network model was trained on nine selected surgical metrics, spanning all three categories and achieved 80% testing accuracy. This study outlines the benefits of integrating artificial neural networks to virtual reality surgical simulators in understanding composites of expertise performance.