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Cui L, Han Y, Liu X, Jiao BL, Su HG, Chai M, Chen M, Shu J, Pu WW, He LR, Han YD. Innovative Clinical Scenario Simulator for Step-by-Step Microsurgical Training. J Reconstr Microsurg 2024. [PMID: 38190988 DOI: 10.1055/a-2240-1305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
BACKGROUND Microsurgical training should be implemented with consideration of operative difficulties that occur in actual clinical situations. We evaluated the effectiveness of a novel clinical scenario simulator for step-by-step microsurgical training that progressed from conventional training to escalated training with additional obstacles. METHODS A training device was designed according to multiple and intricate clinical microsurgery scenarios. Twenty surgical residents with no experience in microsurgery were randomly assigned to either the control group (conventional training curricula, n = 10) or the experimental group (step-by-step training courses, n = 10). After 4 weeks of laboratory practice, the participants were scheduled to perform their first microvascular anastomoses on patients in an operating room. The Global Rating Scale (GRS) scores and operative duration were used to compare microsurgical skills between the two groups. RESULTS There were no significant differences in the participants' baseline characteristics before microsurgical training between the groups with respect to age, sex, postgraduate year, surgical specialty, or mean GRS score (p < 0.05). There were also no significant differences in recipient sites between the two groups (p = 0.735). After training, the GRS scores in both groups were significantly improved (p = 0.000). However, in the actual microsurgical situations, the GRS scores were significantly higher in the experimental than control group (p < 0.05). There was no significant difference in the operative duration between the two groups (p < 0.13). CONCLUSION Compared with a traditional training program, this step-by-step microsurgical curriculum based on our clinical scenario simulator results in significant improvement in acquisition of microsurgical skills.
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Affiliation(s)
- Lei Cui
- Plastic Surgery Hospital (Institute), Chinese Academy of Medical Sciences (CAMS), Peking Union Medical College (PUMC), Beijing, China
| | - Yan Han
- Department of Plastic and Reconstructive Surgery, First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Chinese PLA Medical School, Beijing, China
| | - Xin Liu
- Department of Plastic and Reconstructive Surgery, First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Chinese PLA Medical School, Beijing, China
- Department of Plastic and Aesthetic surgery, Shaoxing Stomatological Hospital, Shaoxing, Zhejiang Province, China
| | - Bao L Jiao
- Department of Pain Treatment, First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei Province, China
| | - Hong G Su
- Department of Medical Engineering, XuHeRui Technology Co., Ltd., Beijing, China
| | - Mi Chai
- Department of Plastic and Reconstructive Surgery, First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Chinese PLA Medical School, Beijing, China
| | - Miao Chen
- Department of Plastic and Reconstructive Surgery, First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Chinese PLA Medical School, Beijing, China
| | - Jun Shu
- Department of Plastic and Reconstructive Surgery, First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Chinese PLA Medical School, Beijing, China
| | - Wen W Pu
- Plastic Surgery Hospital (Institute), Chinese Academy of Medical Sciences (CAMS), Peking Union Medical College (PUMC), Beijing, China
| | - Le R He
- Plastic Surgery Hospital (Institute), Chinese Academy of Medical Sciences (CAMS), Peking Union Medical College (PUMC), Beijing, China
| | - Yu D Han
- Department of Plastic and Reconstructive Surgery, First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Chinese PLA Medical School, Beijing, China
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Bykanov A, Danilov G, Kostumov V, Pilipenko O, Nutfullin B, Rastvorova O, Pitskhelauri D. Artificial Intelligence Technologies in the Microsurgical Operating Room (Review). Sovrem Tekhnologii Med 2023; 15:86-94. [PMID: 37389018 PMCID: PMC10306972 DOI: 10.17691/stm2023.15.2.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Indexed: 07/01/2023] Open
Abstract
Surgery performed by a novice neurosurgeon under constant supervision of a senior surgeon with the experience of thousands of operations, able to handle any intraoperative complications and predict them in advance, and never getting tired, is currently an elusive dream, but can become a reality with the development of artificial intelligence methods. This paper has presented a review of the literature on the use of artificial intelligence technologies in the microsurgical operating room. Searching for sources was carried out in the PubMed text database of medical and biological publications. The key words used were "surgical procedures", "dexterity", "microsurgery" AND "artificial intelligence" OR "machine learning" OR "neural networks". Articles in English and Russian were considered with no limitation to publication date. The main directions of research on the use of artificial intelligence technologies in the microsurgical operating room have been highlighted. Despite the fact that in recent years machine learning has been increasingly introduced into the medical field, a small number of studies related to the problem of interest have been published, and their results have not proved to be of practical use yet. However, the social significance of this direction is an important argument for its development.
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Affiliation(s)
- A.E. Bykanov
- Neurosurgeon, 7 Department of Neurosurgery, Researcher; National Medical Research Center for Neurosurgery named after Academician N.N. Burdenko, Ministry of Healthcare of the Russian Federation, 16, 4 Tverskaya-Yamskaya St., Moscow, 125047, Russia
| | - G.V. Danilov
- Academic Secretary; National Medical Research Center for Neurosurgery named after Academician N.N. Burdenko, Ministry of Healthcare of the Russian Federation, 16, 4 Tverskaya-Yamskaya St., Moscow, 125047, Russia
| | - V.V. Kostumov
- PhD Student, Programmer, the CMC Faculty; Lomonosov Moscow State University, 1 Leninskiye Gory, Moscow, 119991, Russia
| | - O.G. Pilipenko
- PhD Student, Programmer, the CMC Faculty; Lomonosov Moscow State University, 1 Leninskiye Gory, Moscow, 119991, Russia
| | - B.M. Nutfullin
- PhD Student, Programmer, the CMC Faculty; Lomonosov Moscow State University, 1 Leninskiye Gory, Moscow, 119991, Russia
| | - O.A. Rastvorova
- Resident, 7 Department of Neurosurgery; National Medical Research Center for Neurosurgery named after Academician N.N. Burdenko, Ministry of Healthcare of the Russian Federation, 16, 4 Tverskaya-Yamskaya St., Moscow, 125047, Russia
| | - D.I. Pitskhelauri
- Professor, Head of the 7 Department of Neurosurgery; National Medical Research Center for Neurosurgery named after Academician N.N. Burdenko, Ministry of Healthcare of the Russian Federation, 16, 4 Tverskaya-Yamskaya St., Moscow, 125047, Russia
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Franco-González IT, Minor-Martínez A, Ordorica-Flores RM, Sossa-Azuela JH, Pérez-Escamirosa F. Objective psychomotor laparoscopic skills evaluation using a low-cost wearable device based on accelerometry: construct and concurrent validity study. Surg Endosc 2023; 37:3280-3290. [PMID: 36890413 DOI: 10.1007/s00464-023-09953-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 02/12/2023] [Indexed: 03/10/2023]
Abstract
BACKGROUND Motion analysis of surgical maneuvers provides useful quantitative information for the objective evaluation of the surgeons. However, surgical simulation laboratories for laparoscopic training do not usually integrate devices that help quantify the level of skills of the surgeons due to their limited resources and the high costs of new technologies. The purpose of this study is to present the construct and concurrent validity of a low-cost motion tracking system, based on a wireless triaxial accelerometer, employed to objectively evaluate psychomotor skills of surgeons during laparoscopic training. METHODS An accelerometry system, a wireless three-axis accelerometer with appearance of wristwatch, was placed on the dominant hand of the surgeons to register the motion during the laparoscopy practice with the EndoViS simulator, which simultaneously recorded the motion of the laparoscopic needle driver. This study included the participation of 30 surgeons (6 experts, 14 intermediates and 10 novices) who performed the task of intracorporeal knot-tying suture. Using 11 motion analysis parameters (MAPs), the performance of each participant was assessed. Subsequently, the scores of the three groups of surgeons were statistically analyzed. In addition, a validity study was conducted comparing the metrics between the accelerometry-tracking system and the EndoViS hybrid simulator. RESULTS Construct validity was achieved for 8 of the 11 metrics examined with the accelerometry system. Concurrent validity demonstrated that there is a strong correlation between the results of the accelerometry system and the EndoViS simulator in 9 of 11 parameters, showing reliability of the accelerometry system as an objective evaluation method. CONCLUSION The accelerometry system was successfully validated. This method is potentially useful to complement the objective evaluation of surgeons during laparoscopic practice in training environments such as box-trainers and simulators.
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Affiliation(s)
- Iván Tlacaélel Franco-González
- Sección de Bioelectrónica, Departamento de Ingeniería Eléctrica, Centro de Investigación Y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV-IPN), Av. Instituto Politécnico Nacional 2508, Col. San Pedro Zacatenco, 07360, Ciudad de México, México
| | - Arturo Minor-Martínez
- Sección de Bioelectrónica, Departamento de Ingeniería Eléctrica, Centro de Investigación Y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV-IPN), Av. Instituto Politécnico Nacional 2508, Col. San Pedro Zacatenco, 07360, Ciudad de México, México.
| | - Ricardo Manuel Ordorica-Flores
- Departamento de Cirugía Endoscópica, Hospital Infantil de México Federico Gómez, Calle Dr. Márquez No. 162, Cuauhtémoc, Doctores, 06720, Ciudad de México, México
| | - Juan Humberto Sossa-Azuela
- Centro de Investigación en Computación, Instituto Politécnico Nacional, Av. Juan de Dios Bátiz S/N, Esq. Miguel Othón de Mendizábal, Col. Nueva Industrial Vallejo, 07738, Ciudad de México, México
| | - Fernando Pérez-Escamirosa
- Instituto de Ciencias Aplicadas Y Tecnología (ICAT), Universidad Nacional Autónoma de México (UNAM), Circuito Exterior S/N, Ciudad Universitaria, Coyoacán, 04510, Ciudad de México, México
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Cheng SC, Chao YK. Editorial Perspective: Robot-Assisted Evaluation of Robotic Surgical Skills. Ann Surg Oncol 2022; 29:6524-6525. [PMID: 35790587 DOI: 10.1245/s10434-022-12062-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 06/12/2022] [Indexed: 11/18/2022]
Affiliation(s)
| | - Yin-Kai Chao
- Division of Thoracic Surgery, Chang Gung Memorial Hospital-Linkou, Chang Gung University, Taoyuan, Taiwan.
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