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Published in: International Journal of Computer Assisted Radiology and Surgery 2/2023

05-10-2022 | Expert Opinion | Original Article

“Stand-up straight!”: human pose estimation to evaluate postural skills during orthopedic surgery simulations

Authors: Tiphaine Casy, Alexandre Tronchot, Hervé Thomazeau, Xavier Morandi, Pierre Jannin, Arnaud Huaulmé

Published in: International Journal of Computer Assisted Radiology and Surgery | Issue 2/2023

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Abstract

Purpose

Surgery simulators can be used to learn technical and non-technical skills and, to analyse posture. Ergonomic skill can be automatically detected with a Human Pose Estimation algorithm to help improve the surgeon’s work quality. The objective of this study was to analyse the postural behaviour of surgeons and identify expertise-dependent movements. Our hypothesis was that hesitation and the occurrence of surgical instruments interfering with movement (defined as interfering movements) decrease with expertise.

Material and methods

Sixty surgeons with three expertise levels (novice, intermediate, and expert) were recruited. During a training session using an arthroscopic simulator, each participant’s movements were video-recorded with an RGB camera. A modified OpenPose algorithm was used to detect the surgeon's joints. The detection frequency of each joint in a specific area was visualized with a heatmap-like approach and used to calculate a mobility score.

Results

This analysis allowed quantifying surgical movements. Overall, the mean mobility score was 0.823, 0.816, and 0.820 for novice, intermediate and expert surgeons, respectively. The mobility score alone was not enough to identify postural behaviour differences. A visual analysis of each participants’ movements highlighted expertise-dependent interfering movements.

Conclusion

Video-recording and analysis of surgeon’s movements are a non-invasive approach to obtain quantitative and qualitative ergonomic information in order to provide feedback during training. Our findings suggest that the interfering movements do not decrease with expertise but differ in function of the surgeon’s level.
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Metadata
Title
“Stand-up straight!”: human pose estimation to evaluate postural skills during orthopedic surgery simulations
Authors
Tiphaine Casy
Alexandre Tronchot
Hervé Thomazeau
Xavier Morandi
Pierre Jannin
Arnaud Huaulmé
Publication date
05-10-2022
Publisher
Springer International Publishing
Published in
International Journal of Computer Assisted Radiology and Surgery / Issue 2/2023
Print ISSN: 1861-6410
Electronic ISSN: 1861-6429
DOI
https://doi.org/10.1007/s11548-022-02762-5

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