TY - JOUR
T1 - Objective classification of psychomotor laparoscopic skills of surgeons based on three different approaches
AU - Pérez-Escamirosa, Fernando
AU - Alarcón-Paredes, Antonio
AU - Alonso-Silverio, Gustavo Adolfo
AU - Oropesa, Ignacio
AU - Camacho-Nieto, Oscar
AU - Lorias-Espinoza, Daniel
AU - Minor-Martínez, Arturo
N1 - Publisher Copyright:
© 2019, CARS.
PY - 2020/1/1
Y1 - 2020/1/1
N2 - Background: The determination of surgeons’ psychomotor skills in minimally invasive surgery techniques is one of the major concerns of the programs of surgical training in several hospitals. Therefore, it is important to assess and classify objectively the level of experience of surgeons and residents during their training process. The aim of this study was to investigate three classification methods for establishing automatically the level of surgical competence of the surgeons based on their psychomotor laparoscopic skills. Methods: A total of 43 participants, divided into an experienced surgeons group with ten experts (> 100 laparoscopic procedures performed) and non-experienced surgeons group with 24 residents and nine medical students (< 10 laparoscopic procedures performed), performed three tasks in the EndoViS training system. Motion data of the instruments were captured with a video-tracking system built into the EndoViS simulator and analyzed using 13 motion analysis parameters (MAPs). Radial basis function networks (RBFNets), K-star (K*), and random forest (RF) were used for classifying surgeons based on the MAPs’ scores of all participants. The performance of the three classifiers was examined using hold-out and leave-one-out validation techniques. Results: For all three tasks, the K-star method was superior in terms of accuracy and AUC in both validation techniques. The mean accuracy of the classifiers was 93.33% for K-star, 87.58% for RBFNets, and 84.85% for RF in hold-out validation, and 91.47% for K-star, 89.92% for RBFNets, and 83.72% for RF in leave-one-out cross-validation. Conclusions: The three proposed methods demonstrated high performance in the classification of laparoscopic surgeons, according to their level of psychomotor skills. Together with motion analysis and three laparoscopic tasks of the Fundamental Laparoscopic Surgery Program, these classifiers provide a means for objectively classifying surgical competence of the surgeons for existing laparoscopic box trainers.
AB - Background: The determination of surgeons’ psychomotor skills in minimally invasive surgery techniques is one of the major concerns of the programs of surgical training in several hospitals. Therefore, it is important to assess and classify objectively the level of experience of surgeons and residents during their training process. The aim of this study was to investigate three classification methods for establishing automatically the level of surgical competence of the surgeons based on their psychomotor laparoscopic skills. Methods: A total of 43 participants, divided into an experienced surgeons group with ten experts (> 100 laparoscopic procedures performed) and non-experienced surgeons group with 24 residents and nine medical students (< 10 laparoscopic procedures performed), performed three tasks in the EndoViS training system. Motion data of the instruments were captured with a video-tracking system built into the EndoViS simulator and analyzed using 13 motion analysis parameters (MAPs). Radial basis function networks (RBFNets), K-star (K*), and random forest (RF) were used for classifying surgeons based on the MAPs’ scores of all participants. The performance of the three classifiers was examined using hold-out and leave-one-out validation techniques. Results: For all three tasks, the K-star method was superior in terms of accuracy and AUC in both validation techniques. The mean accuracy of the classifiers was 93.33% for K-star, 87.58% for RBFNets, and 84.85% for RF in hold-out validation, and 91.47% for K-star, 89.92% for RBFNets, and 83.72% for RF in leave-one-out cross-validation. Conclusions: The three proposed methods demonstrated high performance in the classification of laparoscopic surgeons, according to their level of psychomotor skills. Together with motion analysis and three laparoscopic tasks of the Fundamental Laparoscopic Surgery Program, these classifiers provide a means for objectively classifying surgical competence of the surgeons for existing laparoscopic box trainers.
KW - Classification
KW - Laparoscopic surgery
KW - Motion analysis
KW - Objective assessment
KW - Training
KW - Video-based tracking
UR - http://www.scopus.com/inward/record.url?scp=85074579939&partnerID=8YFLogxK
U2 - 10.1007/s11548-019-02073-2
DO - 10.1007/s11548-019-02073-2
M3 - Artículo
C2 - 31605351
SN - 1861-6410
VL - 15
SP - 27
EP - 40
JO - International Journal of Computer Assisted Radiology and Surgery
JF - International Journal of Computer Assisted Radiology and Surgery
IS - 1
ER -