Surgical technique analysis using dynamic measurement of surgical instruments for practical laparoscopic surgery training*

To improve the efficiency of surgical skill transfer and proficiency in laparoscopic surgery, an objective method of quantifying surgical skills was developed. Surgical trainings for laparoscopic nephrectomy were conducted using cadavers, and the movements of surgical instruments were measured using Mocap system in 46 trainings. Because the surgical techniques required are different depending on the surgical process, the entire nephrectomy was divided into three surgical processes (Part 1: colon mobilization, Part 2: renal vascularization, and Part 3: dissection of the remaining tissue), and skill analysis was performed for each process. Surgeons were categorized into three groups according to the number of surgical experiences (novice: 0-9 surgeries, intermediate: 10-49 surgeries, and experts: 50 or more). Three-group tests were conducted on 111 features extracted from the surgical instrument movement data. The three-group tests showed that there were significant differences among the three groups in the surgical processes: part 1, part 2, and part 3. Principal component analysis (PCA) was conducted using the features that showed significant differences in the efficiency of the operation.