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      A software-based tool for video motion tracking in the surgical skills assessment landscape

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          Abstract

          Background

          The use of motion tracking has been proved to provide an objective assessment in surgical skills training. Current systems, however, require the use of additional equipment or specialised laparoscopic instruments and cameras to extract the data. The aim of this study was to determine the possibility of using a software-based solution to extract the data.

          Methods

          6 expert and 23 novice participants performed a basic laparoscopic cholecystectomy procedure in the operating room. The recorded videos were analysed using Kinovea 0.8.15 and the following parameters calculated the path length, average instrument movement and number of sudden or extreme movements.

          Results

          The analysed data showed that experts had significantly shorter path length (median 127 cm vs. 187 cm, p = 0.01), smaller average movements (median 0.40 cm vs. 0.32 cm, p = 0.002) and fewer sudden movements (median 14.00 vs. 21.61, p = 0.001) than their novice counterparts.

          Conclusion

          The use of software-based video motion tracking of laparoscopic cholecystectomy is a simple and viable method enabling objective assessment of surgical performance. It provides clear discrimination between expert and novice performance.

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          Most cited references17

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          Virtual Reality Training Improves Operating Room Performance

          To demonstrate that virtual reality (VR) training transfers technical skills to the operating room (OR) environment.
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            Laparoscopic skills training and assessment.

            The introduction of laparoscopic techniques to general surgery was associated with many unnecessary complications, which led to the development of skills laboratories to train novice laparoscopic surgeons. This article reviews the tools currently available for training and assessment in laparoscopic surgery. Medline searches were performed to identify articles with combinations of the following key words: laparoscopy, training, curriculum, virtual reality and assessment. Further articles were obtained by manually searching the reference lists of identified papers. Current training involves the use of box trainers with either innate models or animal tissues; it lacks objective assessment of skill acquisition. Virtual reality simulators have the ability to teach laparoscopic psychomotor skills, and objective assessment is now possible using dexterity-based and video analysis systems. The tools are now available for the development of a structured, competency-based, laparoscopic surgical training programme. Copyright 2004 British Journal of Surgery Society Ltd.
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              Systematic review of randomized controlled trials on the effectiveness of virtual reality training for laparoscopic surgery.

              Surgical training has traditionally been one of apprenticeship. The aim of this review was to determine whether virtual reality (VR) training can supplement and/or replace conventional laparoscopic training in surgical trainees with limited or no laparoscopic experience. Randomized clinical trials addressing this issue were identified from The Cochrane Library trials register, Medline, Embase, Science Citation Index Expanded, grey literature and reference lists. Standardized mean difference was calculated with 95 per cent confidence intervals based on available case analysis. Twenty-three trials (mostly with a high risk of bias) involving 622 participants were included in this review. In trainees without surgical experience, VR training decreased the time taken to complete a task, increased accuracy and decreased errors compared with no training. In the same participants, VR training was more accurate than video trainer (VT) training. In participants with limited laparoscopic experience, VR training resulted in a greater reduction in operating time, error and unnecessary movements than standard laparoscopic training. In these participants, the composite performance score was better in the VR group than the VT group. VR training can supplement standard laparoscopic surgical training. It is at least as effective as video training in supplementing standard laparoscopic training.
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                Author and article information

                Contributors
                s.ganni@tudelft.nl
                Journal
                Surg Endosc
                Surg Endosc
                Surgical Endoscopy
                Springer US (New York )
                0930-2794
                1432-2218
                16 January 2018
                16 January 2018
                2018
                : 32
                : 6
                : 2994-2999
                Affiliations
                [1 ]ISNI 0000 0001 2097 4740, GRID grid.5292.c, Medisign, Industrial Design Engineering, , Delft University of Technology, ; Delft, The Netherlands
                [2 ]ISNI 0000 0004 1803 9448, GRID grid.464934.8, Department of Surgery, , GSL Medical College, ; Rajahmundry, India
                [3 ]ISNI 0000 0004 0398 8384, GRID grid.413532.2, Research and Education, , Catharina Hospital, ; Michelangelolaan 2, 5653 EJ Eindhoven, The Netherlands
                [4 ]GRID grid.461578.9, Department of Pediatric Surgery, , Radboudumc – Amalia Children’s Hospital, ; Nijmegen, The Netherlands
                Author information
                http://orcid.org/0000-0003-2253-0566
                Article
                6023
                10.1007/s00464-018-6023-5
                5956097
                29340824
                4a6c203f-093a-4749-b34d-cb063ad7b229
                © The Author(s) 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 5 September 2017
                : 3 January 2018
                Categories
                New Technology
                Custom metadata
                © Springer Science+Business Media, LLC, part of Springer Nature 2018

                Surgery
                motion tracking,objective assessment,laparoscopic cholecystectomy,laparoscopic skills,training,video-based assessment

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