Comparison of gaze behaviour of trainee and experienced surgeons during laparoscopic gastric bypass
Comparison of gaze behaviour of trainee and experienced surgeons during laparoscopic gastric bypass
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DOI：
10.1002/bjs.10672
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发表时间：
2018-02-01
影响因子：
9.6
通讯作者：
Sodergren, M. H.
中科院分区：
文献类型：
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作者：
Erridge, S.;Ashraf, H.;Sodergren, M. H.
背景：眼动追踪是一种新的工具，可用于客观地描述手术中的技能水平。本研究的主要目的是确定专家和初级外科医生之间的凝视行为进行腹腔镜Roux-en-Y胃旁路（LRYGB）obesity.Methods的差异：这项前瞻性观察研究使用了一个轻量级的眼跟踪装置，以确定专家（超过75个程序）和初级（75个或更少的程序）外科医生之间的凝视行为的差异在定义阶段的LRYGB。主要终点是标准化的停留时间和注视频率。次要终点是眨眼率，最大瞳孔大小和瞳孔changes.Results率：共20个程序（12初级，8专家）进行了分析。与低年级学生相比，专家在解剖角度时在屏幕上的停留时间延长（中位数（范围）91.20（83.40-94.40）对比68.95（59.80-87.60）%; P = 0.001），胃后隧道形成（91.50（85.80-95.50）对比73.60（34.60-90.50）%; P = 0.001）和胃袋形成（86.95（83.60-90.20）对67.60（37.10-80.00）%P < 0.001）。在所有记录的手术节段中，青少年的眨眼频率更高（P < 0.010），并且在所有记录的手术节段中，青少年的最大瞳孔尺寸更大（P < 0.010）。结论：专家组学生对重要刺激的注意力集中程度更高，脑力负荷减少，注意力集中程度更高。这有可能在未来用于高风险评估中的手术技能验证。
Background: Eye tracking presents a novel tool that could be used to profile skill levels in surgery objectively. The primary aim of this study was to identify differences in gaze behaviour between expert and junior surgeons performing a laparoscopic Roux-en-Y gastric bypass (LRYGB) for obesity.Methods: This prospective observational study used a lightweight eye-tracking apparatus to determine the difference in gaze behaviours between expert (more than 75 procedures) and junior (75 or fewer procedures) surgeons at defined stages of LRYGB. Primary endpoints were normalized dwell time and fixation frequency. Secondary endpoints were blink rate, maximum pupil size and rate of pupil change.Results: A total of 20 procedures (12 junior, 8 expert) were analysed. Compared with juniors, experts showed a prolonged dwell time on the screen during angle of His dissection (median (range) 91.20 (83.40-94.40) versus 68.95 (59.80-87.60) per cent; P = 0.001), formation of the retrogastric tunnel (91.50 (85.80-95.50) versus 73.60 (34.60-90.50) per cent; P = 0.001) and gastric pouch formation (86.95 (83.60-90.20) versus 67.60 (37.10-80.00) per cent P < 0.001). Juniors had a greater blink frequency throughout all recorded segments (P < 0.010) and had a larger maximum pupil size during all recorded operative segments (P < 0.010). Rate of pupil change was greater in juniors in all analysed segments (P < 0.010).Conclusion: These results suggest that experts display more focused attention on significant stimuli, alongside experiencing a reduced mental workload and having increased concentration. This has the potential for future use in validation of surgical skill in high-stakes assessment.