Analysis of the structure of surgical activity for a suturing and knot-tying task

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

doi:10.1371/journal.pone.0149174

Analysis of the structure of surgical activity for a suturing and knot-tying task

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

Whiting School of Engineering

Research output: Contribution to journal › Article › peer-review

14 Scopus citations

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.

Original language	English (US)
Article number	e0149174
Journal	PloS one
Volume	11
Issue number	3
DOIs	https://doi.org/10.1371/journal.pone.0149174
State	Published - Mar 2016

ASJC Scopus subject areas

General

Access to Document

10.1371/journal.pone.0149174

Cite this

@article{239c780921954b26b0b005bbada28ac3,

title = "Analysis of the structure of surgical activity for a suturing and knot-tying task",

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.",

author = "Vedula, {S. Swaroop} and Malpani, {Anand O.} and Lingling Tao and George Chen and Yixin Gao and Piyush Poddar and Narges Ahmidi and Christopher Paxton and Rene Vidal and Sanjeev Khudanpur and Hager, {Gregory D.} and Chen, {Chi Chiung Grace}",

note = "Publisher Copyright: {\textcopyright} 2016 Vedula et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.",

year = "2016",

month = mar,

doi = "10.1371/journal.pone.0149174",

language = "English (US)",

volume = "11",

journal = "PloS one",

issn = "1932-6203",

publisher = "Public Library of Science",

number = "3",

}

TY - JOUR

T1 - Analysis of the structure of surgical activity for a suturing and knot-tying task

AU - Vedula, S. Swaroop

AU - Malpani, Anand O.

AU - Tao, Lingling

AU - Chen, George

AU - Gao, Yixin

AU - Poddar, Piyush

AU - Ahmidi, Narges

AU - Paxton, Christopher

AU - Vidal, Rene

AU - Khudanpur, Sanjeev

AU - Hager, Gregory D.

AU - Chen, Chi Chiung Grace

N1 - Publisher Copyright: © 2016 Vedula et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PY - 2016/3

Y1 - 2016/3

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=84962214149&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84962214149&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0149174

DO - 10.1371/journal.pone.0149174

M3 - Article

C2 - 26950551

AN - SCOPUS:84962214149

SN - 1932-6203

VL - 11

JO - PloS one

JF - PloS one

IS - 3

M1 - e0149174

ER -

Analysis of the structure of surgical activity for a suturing and knot-tying task

Abstract

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this