Title: Instrument Orientation-Based Metrics for Surgical Skill Evaluation in Robot-Assisted and Open Needle Driving,
Abstract: The technical skill of surgeons directly impacts patient outcomes. Advanced
tracking systems enable the development of objective motion-based metrics for
skill evaluation, but these metrics are not sufficient to evaluate the
performance in complex surgical tasks. In this study, we developed metrics for
surgical skill evaluation that are based on the orientation of the surgical
instruments. Experienced robotic surgeons and novice users performed
teleoperated (using the da Vinci Research Kit) and open needle-driving. Task
time and the rate of orientation change successfully distinguished between
experienced surgeons and novice users. Path length and the normalized angular
displacement allowed for a good separation only in part of the experiment. Our
new promising metrics for surgical skill evaluation captured technical aspects
that are taught during surgeons' training. They provide complementing
evaluation to those of classical metrics. Orientation-based metrics add value
to skill assessment and may be an adjunct to classic objective metrics
providing more granular discrimination of skills.