Document Type
Article
Publication Date
7-12-2022
Abstract
Introduction: Surgical skill evaluation while performing minimally invasive surgeries is a highly complex task. It is important to objectively assess an individual's technical skills throughout surgical training to monitor progress and to intervene when skills are not commensurate with the year of training. The miniaturization of wireless wearable platforms integrated with sensor technology has made it possible to noninvasively assess muscle activations and movement variability during performance of minimally invasive surgical tasks. Our objective was to use electromyography (EMG) to deconstruct the motions of a surgeon during robotic suturing (RS) and distinguish quantifiable movements that characterize the skill of an experienced expert urologic surgeon from trainees.
Methods: Three skill groups of participants, novice (n = 11), intermediate (n = 12), and expert (n = 3), were enrolled in the study. A total of 12 wireless wearable sensors consisting of surface EMGs and accelerometers were placed along upper extremity muscles to assess muscle activations and movement variability, respectively. Participants then performed a RS task.
Results: EMG-based parameters, total time, dominant frequency, and cumulative muscular workload, were significantly different across the three skill groups. We also found nonlinear movement variability parameters such as correlation dimension, Lyapunov exponent trended differently across the three skill groups.
Conclusions: These findings suggest that economy of motion variables and nonlinear movement variabilities are affected by surgical experience level. Wearable sensor signal analysis could make it possible to objectively evaluate surgical skill level periodically throughout the residency training experience.
Recommended Citation
Rahul Soangra, Pengbo Jiang, Daniel Haik, Perry Xu, Andrew Brevik, Akhil Peta, Shlomi Tapiero, Jaime Landman, Emmanuel John, and Ralph V. Clayman. Beyond Efficiency: Surface Electromyography Enables Further Insights into the Surgical Movements of Urologists. Journal of Endourology. Oct 2022.1355-1361. http://doi.org/10.1089/end.2022.0120
Peer Reviewed
1
Copyright
Mary Ann Liebert
Comments
This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Journal of Endourology, volume 36, issue 10, in 2022 following peer review. This article may not exactly replicate the final published version. The definitive publisher-authenticated version is available online at http://doi.org/10.1089/end.2022.0120.