Motion analysis for better understanding of psychomotor skills in laparoscopy: objective assessment-based simulation tra
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Motion analysis for better understanding of psychomotor skills in laparoscopy: objective assessment‑based simulation training using animal organs Koki Ebina2 · Takashige Abe1 · Madoka Higuchi1 · Jun Furumido1 · Naoya Iwahara1 · Masafumi Kon1 · Kiyohiko Hotta1 · Shunsuke Komizunai2 · Yo Kurashima3 · Hiroshi Kikuchi1 · Ryuji Matsumoto1 · Takahiro Osawa1 · Sachiyo Murai1 · Teppei Tsujita4 · Kazuya Sase5 · Xiaoshuai Chen6 · Atsushi Konno2 · Nobuo Shinohara1 Received: 5 May 2020 / Accepted: 25 August 2020 © The Author(s) 2020
Abstract Background Our aim was to characterize the motions of multiple laparoscopic surgical instruments among participants with different levels of surgical experience in a series of wet-lab training drills, in which participants need to perform a range of surgical procedures including grasping tissue, tissue traction and dissection, applying a Hem-o-lok clip, and suturing/knotting, and digitize the level of surgical competency. Methods Participants performed tissue dissection around the aorta, dividing encountered vessels after applying a Hemo-lok (Task 1), and renal parenchymal closure (Task 2: suturing, Task 3: suturing and knot-tying), using swine cadaveric organs placed in a box trainer under a motion capture (Mocap) system. Motion-related metrics were compared according to participants’ level of surgical experience (experts: 50 ≤ laparoscopic surgeries, intermediates: 10–49, novices: 0–9), using the Kruskal–Wallis test, and significant metrics were subjected to principal component analysis (PCA). Results A total of 15 experts, 12 intermediates, and 18 novices participated in the training. In Task 1, a shorter path length and faster velocity/acceleration/jerk were observed using both scissors and a Hem-o-lok applier in the experts, and Hemo-lok-related metrics markedly contributed to the 1st principal component on PCA analysis, followed by scissors-related metrics. Higher-level skills including a shorter path length and faster velocity were observed in both hands of the experts also in tasks 2 and 3. Sub-analysis showed that, in experts with 100 ≤ cases, scissors moved more frequently in the “close zone (0 ≤ to
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