Measurement of Surgical Dexterity Using Motion Analysis of Simple Bench Tasks |
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Authors: | Simon D Bann Mansoor S Khan Ara W Darzi |
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Institution: | (1) Department of Surgical Oncology and Technology, Faculty of Medicine, Imperial College of Science, Technology, and Medicine, 10th Floor QEQM Wing, St. Mary’s Hospital, W2 1NY, London, UK, |
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Abstract: | Abstract
The possibility of using quantitative motion analysis for objective assessment of simple surgical dexterity is investigated
using the Imperial College Surgical Assessment Device (ICSAD) with qualitative analysis undertaken by inspection. Bench-top
knot tying and suturing skills were performed and examined for the ability to discriminate between surgeons of varying experience.
These exercises were found to discriminate significantly between junior and senior surgeons in terms of both time taken and
the number of movements required. The relation between time and motion was found to be variable depending on what skill was
being undertaken: simple suturing, suturing at depth, or knot tying (1.71 vs. 1.86 vs. 2.36; p = 0.002 for 1 vs. 2; p < 0.001 for others). When the number of movements in a minute (standardized movements per minute) were considered, both groups
were found to work at a similar rate, depending on the task, implying that the more experienced surgeon is more economical,
performing the same exercise with fewer moves rather than with higher speed. Motion analysis exhibits face and construct validity
and is a reliable assessment of simple surgical dexterity. Its use for objective assessment of dexterity and competence should
be encouraged. |
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