Automated Assessment of the Effects of System Limitations Based upon Data collect

描述（由申请人提供）：截至2007年年中，已经安装的达芬奇机器人手术系统超过700台，机器人根治性前列腺切除术目前是前列腺癌切除的主要手术方式。仅在美国，就有数以万计的手术是用达芬奇系统进行的。达芬奇虽然是唯一的商用机器人手术系统，但它现在已经广泛使用，并在临床大量使用，这使得对技能发展的研究成为医疗质量的关键问题。本研究旨在通过达芬奇的应用程序编程接口（API）建立、部署和验证一个基础设施，用于系统地收集外科医生在机器人手术训练期间的定量运动测量、系统事件和相应的同步视频数据（过程数据）。这将允许手术运动和临床事件的研究不受干扰和不修改的实验传感器和工具。这是一个独特的机会，将自动测量系统集成到目前由Intuitive Surgical开发的多中心机器人手术住院医师计划中，为更多的机器人手术学员提供透明的访问。迄今为止，大多数机器人手术的手术评估方法都是基于人工的、主观的手术技术评估（例如OSATS），而没有考虑系统或操作技能。此外，它们仅限于一小部分用户。自动化的客观评估框架，例如所建议的系统，将更适合集成到用于测量系统操作技能获取的培训课程中。将这项工作扩展到统计分析，也可以对手术技能进行客观评估。公共卫生相关性：机器人前列腺切除术是治疗晚期前列腺癌的主要方法，机器人子宫切除术和其他妇科手术正在以类似的增长率被采用。为了训练未来的外科医生有效地操作这些机器人设备，并更好地设计未来的设备，越来越需要了解机器人手术的复杂元素对机器人系统训练和机器人手术技能获取的影响。为了满足这一需求，这项工作创建了第一个系统获取的机器人手术训练数据资源，并研究了系统限制影响的自动评估。

DESCRIPTION (provided by applicant): There are over 700 installed da Vinci robotic surgery systems as of mid 2007 and robotic radical prostatectomies are now the dominant modality of operation for removal of prostates with cancer. Tens of thousands of procedures are performed with da Vinci systems in the United States alone. The da Vinci, even though it's the only commercial robotic surgery system, is now widely available and operating at a clinical volume that makes the investigation of skill development a crucial issue in quality of care. This research aims to establish, deploy, and validate an infrastructure for systematically collecting quantitative motion measurements, system events, and corresponding synchronized video data (procedure data) from surgeons for the duration of their robotic surgery training via the application programming interface (API) of the da Vinci. This will allow surgical motions and clinical events to be studied undisturbed and unmodified by experimental sensors and tools. There is a unique opportunity to integrate an automatic measurement system into a multi-center robotic surgery residency program being presently developed by Intuitive Surgical providing transparent access to a larger number of robotic surgery trainees. To date, most methods of surgical evaluation of robotic surgery are based on manual, subjective evaluation of surgical technique (e.g. the OSATS) and have not looked at system or operation skills. Further, they have been limited to a small set of users. Automated objective assessment frameworks such as the proposed system will be far more suitable for integration into a training curriculum for measurement of system operation skill acquisition. Extension of this work to include statistical analysis may also allow objective assessments for surgical skills. PUBLIC HEALTH RELEVANCE: Robotic prostatectomies are dominant method of treating late state prostate cancer, and robotic hysterectomies and other gynecological procedures are being adopted at similar growth rates. To train tomorrow's surgeons to operate these robotic devices efficiently and to better design future devices, there is an increasing need to understand the effects of complex elements of robotic surgery affecting robotic system training as well as robotic surgery skill acquisition. To meet this need, this work creates the first systematically acquired resource of training data from robotic surgery, and investigates automatic assessment for the effects of system limitations.