Relevance of Motion-Related Assessment Metrics in Laparoscopic Surgery
Relevance of Motion-Related Assessment Metrics in Laparoscopic Surgery
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DOI：
10.1177/1553350612459808
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发表时间：
2013-06-01
影响因子：
1.5
通讯作者：
Gomez, Enrique J.
中科院分区：
文献类型：
--
作者：
Oropesa, Ignacio;Chmarra, Magdalena K.;Gomez, Enrique J.
导论.运动指标已成为一个重要的信息来源时，解决手术的专业知识的评估。然而，它们与不同手术技巧的直接关系尚未得到充分探讨。本研究的目的是调查的相关性运动相关指标的基本心理腹腔镜技能的评价过程中，其相关性与不同的能力寻求测量。方法.提出了一个任务定义和度量分析的框架。首先与专家委员会进行了一项探索性调查，以确定评估基本心理技能的指标。根据该调查的结果，设计了3个新的手术评估任务。进行了面部和结构验证，重点是运动相关的指标。任务由42名参与者（16名新手，22名居民和4名专家）执行。使用TrEndo跟踪系统记录腹腔镜器械的移动并进行分析。结果时间，路径长度和深度显示所有3个任务的结构效度。运动平滑度和空闲时间也显示出有效性的任务，涉及双手协调和任务，需要一个更战术的方法，分别。此外，运动平滑度和平均速度显示出很高的内部一致性，证明它们是所有分析指标中最独立于任务的指标。结论运动指标是评估基本心理技能的补充和有效的，其相关性取决于被评估的技能。更大规模的临床实施，结合质量性能信息，将使我们更深入地了解本研究中所示结果的相关性。
Introduction. Motion metrics have become an important source of information when addressing the assessment of surgical expertise. However, their direct relationship with the different surgical skills has not been fully explored. The purpose of this study is to investigate the relevance of motion-related metrics in the evaluation processes of basic psychomotor laparoscopic skills and their correlation with the different abilities sought to measure. Methods. A framework for task definition and metric analysis is proposed. An explorative survey was first conducted with a board of experts to identify metrics to assess basic psychomotor skills. Based on the output of that survey, 3 novel tasks for surgical assessment were designed. Face and construct validation was performed, with focus on motion-related metrics. Tasks were performed by 42 participants (16 novices, 22 residents, and 4 experts). Movements of the laparoscopic instruments were registered with the TrEndo tracking system and analyzed. Results. Time, path length, and depth showed construct validity for all 3 tasks. Motion smoothness and idle time also showed validity for tasks involving bimanual coordination and tasks requiring a more tactical approach, respectively. Additionally, motion smoothness and average speed showed a high internal consistency, proving them to be the most task-independent of all the metrics analyzed. Conclusion. Motion metrics are complementary and valid for assessing basic psychomotor skills, and their relevance depends on the skill being evaluated. A larger clinical implementation, combined with quality performance information, will give more insight on the relevance of the results shown in this study.