1. Background Measurements of the Level of Surgical Expertise Using Flight Path Analysis fr.pdf

Measurements of the Level of Surgical Expertise Using Flight Path Analysis from da Vinci? Robotic Surgical System Lawton Verner1, Dmitry Oleynikov, MD1, Stephen Holtmann1, Hani Haider, Ph D1, Leonid Zhukov, Ph D2 1 University of Nebraska Medical Center, Omaha, NE 2 California Institute of Technology, Pasadena, CA email: doleynik@ URL: /mis Abstract. Laparoscopic surgical procedures require precise hand and eye coordination based on a 2-dimensional representation of 3-dimensional space. Currently, no metric exists to guide the educational process while surgeons are still on the learning curve. In this paper, we propose to identify and qualify the patterns of movements recorded from the da Vinci? robotic surgical system (Intuitive Surgical, Sunnyvale CA) that are most consistent with mastery and can define levels of proficiency. We have recorded velocities and positions of complex movements made by both novice and expert surgeons using da Vinci ? system and performed geometric and statistical analysis of the data. 1. Background Surgical skill is difficult to learn and ultimate competency is even more difficult to define and measure. To accurately assess a physician’s technical skills, an objective analysis method must be established. Current methods of assessing surgical skill include subjective testing procedures which require an expert in the field to judge the aptitude of a lesser experienced surgeon [1,7]. The Minimally Invasive Surgical Trainer; Virtual Reality (MIST VR) represents the first attempt to quantify movements by a surgeon and therefore draw conclusions concerning the skill level. Gallagher et al. demonstrated that experts performed better and therefore could be distinguished form novice surgeons [4]. This, however, was done in a virtual reality trainer and cannot be easily adapted to clinical practice. To obtain practical assessment of surgical skill, direct procedures must be analyzed to en