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Analysis of the Structure of Surgical Activity for a Suturing and Knot-Tying Task

Author

Listed:
  • S Swaroop Vedula
  • Anand O Malpani
  • Lingling Tao
  • George Chen
  • Yixin Gao
  • Piyush Poddar
  • Narges Ahmidi
  • Christopher Paxton
  • Rene Vidal
  • Sanjeev Khudanpur
  • Gregory D Hager
  • Chi Chiung Grace Chen

Abstract

Background: Surgical tasks are performed in a sequence of steps, and technical skill evaluation includes assessing task flow efficiency. Our objective was to describe differences in task flow for expert and novice surgeons for a basic surgical task. Methods: We used a hierarchical semantic vocabulary to decompose and annotate maneuvers and gestures for 135 instances of a surgeon’s knot performed by 18 surgeons. We compared counts of maneuvers and gestures, and analyzed task flow by skill level. Results: Experts used fewer gestures to perform the task (26.29; 95% CI = 25.21 to 27.38 for experts vs. 31.30; 95% CI = 29.05 to 33.55 for novices) and made fewer errors in gestures than novices (1.00; 95% CI = 0.61 to 1.39 vs. 2.84; 95% CI = 2.3 to 3.37). Transitions among maneuvers, and among gestures within each maneuver for expert trials were more predictable than novice trials. Conclusions: Activity segments and state flow transitions within a basic surgical task differ by surgical skill level, and can be used to provide targeted feedback to surgical trainees.

Suggested Citation

  • S Swaroop Vedula & Anand O Malpani & Lingling Tao & George Chen & Yixin Gao & Piyush Poddar & Narges Ahmidi & Christopher Paxton & Rene Vidal & Sanjeev Khudanpur & Gregory D Hager & Chi Chiung Grace C, 2016. "Analysis of the Structure of Surgical Activity for a Suturing and Knot-Tying Task," PLOS ONE, Public Library of Science, vol. 11(3), pages 1-14, March.
    • Handle: RePEc:plo:pone00:0149174
    DOI: 10.1371/journal.pone.0149174
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