Abstract
BackgroundMotion tracking during live surgeries may be used to assess surgeons’ intra-operative performance, provide feedback, and predict outcome. Current assessment protocols rely on human observations, controlled laboratory settings, or tracking technologies not suitable for live operating theatres. In this study, a novel method for motion tracking of live open-heart surgery was developed, and evaluated. Materials and methodsThree-D-printed ‘tracking die’ with miniature markers were fitted to DeBakey forceps. The surgical field was recorded with a video camera mounted above the operating table. Software was developed for tracking the die from the recordings. The system was tested on five open-heart procedures. Surgeons were asked to report subjective system related concerns during live surgery and assess the weight of the die on blind test. The accuracy of the system was evaluated against ground truth generated by a robot. ResultsThe 3D-printed die weighed 6 g and tolerated sterilization with hydrogen peroxide, which added approximately 13% to the mass of the forceps. Surgeons sensed a shift in the balance of the instrument but could on blind test not correctly verify changes in weight. When two or more markers were detected, the 3D position estimate was on average within 2-3 mm, and 1.1-2.6 degrees from ground truth. Computational time was 30-50 ms per frame on a standard laptop. ConclusionsThe vision-based motion tracking system was applicable for live surgeries with negligible inconvenience to the surgeons. Motion data was extracted with acceptable accuracy and speed at low computational cost.
Highlights
There is an ongoing effort at teaching institutions to formalize and structure surgical training, and a growing demand fromStenmark et al Vision-based Surgical Motion Tracking the public for transparency and quality assurance in surgical care
The system consists of two hardware components: a novel tracking die, labeled with Aruco markers,[8,9] that was attached to the end of DeBakey forceps, and a consumer grade video camera (Sony Handycam FDR-AX53, Sony Corporation, Japan)
All four reported that they perceived a slight shift of balance and increase in the weight of the DeBakey forceps, but this did not affect their performance in terms of speed and precision during live surgery
Summary
There is an ongoing effort at teaching institutions to formalize and structure surgical training, and a growing demand fromStenmark et al Vision-based Surgical Motion Tracking the public for transparency and quality assurance in surgical care. A trainee’s surgical proficiency can be judged by a senior expert, who score their performance using grading tools such as Objective Structured Assessment of Technical Skills (OSATS)[1] In this setting, the candidate performs surgery on a simulated or live animal model while an expert assesses their technical performance with respect to procedure specific tasks and general surgical skills such as how well they handle tissue, economy of movement, instrument handling, flow of operation, and forward planning.[1] Proficiency-based progression is another method that divide a procedure into steps and evaluate each step using a well-defined metric. Motion data was extracted with acceptable accuracy and speed at low computational cost
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