Objective performance indicators of cardiothoracic residents are associated with vascular injury during robotic-assisted lobectomy on porcine models.

Autor: Lazar JF; Department of Surgery, Division of Thoracic Surgery, MedStar Georgetown University Hospital, 110 Irving St, G-253, Washington, DC, 20010, USA. John.f.lazar@medstar.net., Brown K; Data and Analytics, Intuitive Surgical, Inc., Sunnyvale, CA, USA., Yousaf S; Data and Analytics, Intuitive Surgical, Inc., Sunnyvale, CA, USA., Jarc A; Data and Analytics, Intuitive Surgical, Inc., Sunnyvale, CA, USA., Metchik A; Department of General Surgery, MedStar Georgetown University Hospital, Washington, DC, USA., Henderson H; Department of Surgery, Division of Thoracic Surgery, MedStar Georgetown University Hospital, 110 Irving St, G-253, Washington, DC, 20010, USA., Feins RH; Division of Thoracic Surgery, University of North Carolina, Chapel Hill, NC, USA., Sancheti MS; Division of Thoracic Surgery, Emory University, Atlanta, GA, USA., Lin J; Division of Thoracic Surgery, University of Michigan, Ann Arbor, MI, USA., Yang S; Division of Thoracic Surgery, Johns Hopkins University, Baltimore, MD, USA., Nesbitt J; Department of Thoracic Surgery, Vanderbilt University, Nashville, TN, USA., D'Souza D; Division of Thoracic Surgery, The Ohio State University, Columbus, OH, USA., Oh DS; Data and Analytics, Intuitive Surgical, Inc., Sunnyvale, CA, USA.; Division of Thoracic Surgery, University of Southern California, Los Angeles, CA, USA.
Jazyk: angličtina
Zdroj: Journal of robotic surgery [J Robot Surg] 2023 Apr; Vol. 17 (2), pp. 669-676. Date of Electronic Publication: 2022 Oct 28.
DOI: 10.1007/s11701-022-01476-9
Abstrakt: Surgical training relies on subjective feedback on resident technical performance by attending surgeons. A novel data recorder connected to a robotic-assisted surgical platform captures synchronized kinematic and video data during an operation to calculate quantitative, objective performance indicators (OPIs). The aim of this study was to determine if OPIs during initial task of a resident's robotic-assisted lobectomy (RL) correlated with bleeding during the procedure. Forty-six residents from the 2019 Thoracic Surgery Directors Association Resident Boot Camp completed RL on an ex vivo perfused porcine model while continuous video and kinematic data were recorded. For this pilot study, RL was segmented into 12 tasks and OPIs were calculated for the initial major task. Cases were reviewed for major bleeding events and OPIs of bleeding cases were compared to those who did not. Data from 42 residents were complete and included in the analysis. 10/42 residents (23.8%) encountered bleeding: 10/40 residents who started with superior pulmonary vein exposure and 0/2 residents who started with pulmonary artery exposure. Twenty OPIs for both hands were assessed during the initial task. Six OPIs related to instrument usage or smoothness of motion were significant for bleeding. Differences were statistically significant for both hands (p < 0.05). OPIs showing bimanual asymmetry indicated lower proficiency. This study demonstrates that kinematic and video analytics can establish a correlation between objective performance metrics and bleeding events in an ex vivo perfused lobectomy. Further study could assist in the development of focused exercises and simulation on objective domains to help improve overall performance and reducing complications during RL.
(© 2022. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.)
Databáze: MEDLINE
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