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International Journal of Computer Assisted Radiology and Surgery
Published in: International Journal of Computer Assisted Radiology and Surgery 11/2020

01-11-2020 | Original Article

Clearness of operating field: a surrogate for surgical skills on in vivo clinical data

Authors: Daochang Liu, Tingting Jiang, Yizhou Wang, Rulin Miao, Fei Shan, Ziyu Li

Published in: International Journal of Computer Assisted Radiology and Surgery | Issue 11/2020

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Abstract

Purpose

Automatic surgical skill assessment is an emerging field beneficial to both efficiency and quality of surgical education and practice. Prior works largely evaluate skills on elementary tasks performed in the simulation laboratory, which cannot fully reflect the variety of intraoperative circumstances in the real operating room. In this paper, we attempt to fill this gap by expanding surgical skill assessment onto a clinical dataset including fifty-seven in vivo surgeries.

Methods

To tackle the workflow and device constraints in the clinical setting, we propose a robust and non-interruptive surrogate for surgical skills, namely the clearness of operating field (COF), which shows strong correlation with overall skills and high inter-annotator consistency on our clinical data. Then, an automatic model based on neural networks is developed to regress surgical skills through the surrogate of COF using only video as input.

Results

The automatic model achieves 0.595 Spearman’s correlation with the ground truth of overall technical skill, which even exceeds the human performance of junior surgeons. Moreover, an exploratory study is conducted to validate the skill predictions against the clinical outcomes of patients.

Conclusion

Our results demonstrate that the surrogate of COF is promising and the approach is potentially applicable to clinical practice.
Appendix
Available only for authorised users
Footnotes
1
Complication data are obtained from the medical records and prospective registration database at the hospital. See the supplementary for details.
 
2
The significant level is at \({p} \le 0.05/3 = 0.0167\) based on Bonferroni correction for multiple comparisons.
 
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Metadata
Title
Clearness of operating field: a surrogate for surgical skills on in vivo clinical data
Authors
Daochang Liu
Tingting Jiang
Yizhou Wang
Rulin Miao
Fei Shan
Ziyu Li
Publication date
01-11-2020
Publisher
Springer International Publishing
Published in
International Journal of Computer Assisted Radiology and Surgery / Issue 11/2020
Print ISSN: 1861-6410
Electronic ISSN: 1861-6429
DOI
https://doi.org/10.1007/s11548-020-02267-z

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