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Surgical Endoscopy

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Open Access 01-05-2019

Surgical phase modelling in minimal invasive surgery

Authors: F. C. Meeuwsen, F. van Luyn, M. D. Blikkendaal, F. W. Jansen, J. J. van den Dobbelsteen

Published in: Surgical Endoscopy | Issue 5/2019

Abstract

Background

Surgical Process Modelling (SPM) offers the possibility to automatically gain insight in the surgical workflow, with the potential to improve OR logistics and surgical care. Most studies have focussed on phase recognition modelling of the laparoscopic cholecystectomy, because of its standard and frequent execution. To demonstrate the broad applicability of SPM, more diverse and complex procedures need to be studied. The aim of this study is to investigate the accuracy in which we can recognise and extract surgical phases in laparoscopic hysterectomies (LHs) with inherent variability in procedure time. To show the applicability of the approach, the model was used to automatically predict surgical end-times.

Methods

A dataset of 40 video-recorded LHs was manually annotated for instrument use and divided into ten surgical phases. The use of instruments provided the feature input for building a Random Forest surgical phase recognition model that was trained to automatically recognise surgical phases. Tenfold cross-validation was performed to optimise the model for predicting the surgical end-time throughout the procedure.

Results

Average surgery time is 128 ± 27 min. Large variability within specific phases is seen. Overall, the Random Forest model reaches an accuracy of 77% recognising the current phase in the procedure. Six of the phases are predicted accurately over 80% of their duration. When predicting the surgical end-time, on average an error of 16 ± 13 min is reached throughout the procedure.

Conclusions

This study demonstrates an intra-operative approach to recognise surgical phases in 40 laparoscopic hysterectomy cases based on instrument usage data. The model is capable of automatic detection of surgical phases for generation of a solid prediction of the surgical end-time.

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Title: Surgical phase modelling in minimal invasive surgery
Authors: F. C. Meeuwsen
F. van Luyn
M. D. Blikkendaal
F. W. Jansen
J. J. van den Dobbelsteen
Publication date: 01-05-2019
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 5/2019
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-018-6417-4

At a glance: The STEP trials

Springer Medicine

Surgical phase modelling in minimal invasive surgery

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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