Discrete and Process Automation

Data from Expert Surgeons Could Help Train Next-generation Novices

11 September 2018

Andrew Hung, MD, of the Keck School of Medicine of USC, stands in front of a robotic surgery system. Source: Van UrfalianAndrew Hung, MD, of the Keck School of Medicine of USC, stands in front of a robotic surgery system. Source: Van Urfalian

Researchers from the Keck School of Medicine at the University of Southern California (USC) are creating a new technology that can deconstruct a surgeon’s robotic surgery skills and create new methods to teach future surgeons how to operate with robotics.

The team plugged a data recorder into a robotic surgery system. The recorder provided researchers with data from many prostatectomy surgeries operated by both novice and expert surgeons. They analyzed this data to decode surgical skills and developed a needle-driving gesture classification system that helps inform student surgeries.

"Although robotic surgery is a widely adopted minimally invasive option for treating prostate cancer, standardized training for it doesn't exist yet," says the study's corresponding author, Dr. Andrew Hung, assistant professor of clinical urology at the Keck School. "In order to create a methodical, streamlined training tutorial for this main reconstruction step of the prostate surgery, we relied on automated performance metrics and observation to objectively measure surgeon performance."

The video and movement data gathered from 70 surgeries helps the team determine which future robotics surgeons need to be taught and the education areas that need adjustment. The data showed the expert robotics surgeons were better at completion time, instrument movement efficiency and camera manipulation than novice surgeons. The data showed fewer needle-driving attempts and less tissue trauma in patients who had been operated on by a robotic surgery expert.

The team identified 14 common needle-driving gestures used most often in surgery. The gestures were made up of a combination of forehand, backhand, flush-hand, overhand and underhand movements. Random combinations of the gestures, a sign of lower efficiency exhibited mostly by novices, were most associated with more needle-driving attempts and more tissue trauma.

The data and research came together to ultimately create a tutorial for robotic surgery systems. The tutorial is currently being tested with students at the Keck School.

"While there is no single perfect way to do a perfect operation, creating a standardized method for robotic surgery training provides surgeons a common training ground," Hung says.

The paper on this study was published in The Journal of Urology.

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