Identifying Kinematic Markers Associated with Intraoperative Stress during Surgical Training Tasks
Identifying Kinematic Markers Associated with Intraoperative Stress during Surgical Training Tasks
复制标题
识别手术训练任务期间与术中应力相关的运动学标记
DOI：
10.1109/ismr48346.2021.9661482
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Fey, Ann Majewicz
中科院分区：
文献类型：
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作者：
Zheng, Yi;Leonard, Grey;Tellez, Juan;Zeh, Herbert;Fey, Ann Majewicz
压力水平的增加会损害外科医生的工作表现和手术中患者的安全。本研究的目的是通过对运动学数据的分析，探讨短期应激源对腹腔镜手术效果的影响。在这项IRB批准的研究中，30名受试者被随机分为两组。控制组被要求在听正常模拟生命体征的同时，在静默主持人的观察下，使用FLS训练器完成延长持续时间的钉子转移任务(6分钟)。应激组完成了相同的任务，但听取了一段时间的模拟患者生命体征的逐渐恶化，以及主持人的批判性口头反馈，最终以30秒的心脏骤停和模拟患者的呼气为终点。对于所有受试者，使用安装在腹腔镜器械手柄上的电磁追踪器记录视频和位置数据。对时间序列的速度、加速度和挺度数据以及路径长度和体积经济性进行了统计分析。临床应激源导致较高的速度、加速度、挺度和路径长度以及较低的体积经济性。使用改进的OSATS技术进行客观评估时，应激组的得分也明显低于对照组。这项研究显示了使用时间序列运动学数据来近实时识别腹腔镜手术中的应激状态的潜在可行性和优势。这些数据可能有助于设计未来的机器人辅助算法，以减少压力对手术性能的不利影响。
Increased levels of stress can impair surgeon performance and patient safety during surgery. The aim of this study is to investigate the effect of short term stressors on laparoscopic performance through analysis of kinematic data. Thirty subjects were randomly assigned into two groups in this IRB-approved study. The control group was required to finish an extended-duration peg transfer task (6 minutes) using the FLS trainer while listening to normal simulated vital signs and while being observed by a silent moderator. The stressed group finished the same task but listened to a period of progressively deteriorating simulated patient vitals, as well as critical verbal feedback from the moderator, which culminated in 30 seconds of cardiac arrest and expiration of the simulated patient. For all subjects, video and position data using electromagnetic trackers mounted on the handles of the laparoscopic instruments were recorded. A statistical analysis comparing time-series velocity, acceleration, and jerk data, as well as path length and economy of volume was conducted. Clinical stressors lead to significantly higher velocity, acceleration, jerk, and path length as well as lower economy of volume. An objective evaluation score using a modified OSATS technique was also significantly worse for the stressed group than the control group. This study shows the potential feasibility and advantages of using the time-series kinematic data to identify the stressful conditions during laparoscopic surgery in near-real-time. This data could be useful in the design of future robot-assisted algorithms to reduce the unwanted effects of stress on surgical performance.