Visual behaviour in robotic surgery – demonstrating the validity of the simulated environment
File(s)
Accepted version
Author(s)
Dilley, JAmes
Singh, H
Pratt, P
Darzi, Ara
Mayer, E
Type
Journal Article
Abstract
Background
Eye metrics provide insight into surgical behaviour allowing differentiation of performance, however have not been used in robotic surgery. This study explores eye metrics of robotic surgeons in training in simulated and real tissue environments.
Methods
Following the Fundamentals of Robotic Surgery (FRS), training curriculum novice robotic surgeons were trained to expert‐derived benchmark proficiency using real tissue on the da Vinci Si and the da Vinci skills simulator (dVSS) simulator. Surgeons eye metrics were recorded using eye‐tracking glasses when both “novice” and “proficient” in both environments. Performance was assessed using Global Evaluative Assessment of Robotic skills (GEARS) and numeric psychomotor test score (NPMTS) scores.
Results
Significant (P ≤ .05) correlations were seen between pupil size, rate of change and entropy, and associated GEARS/NPMTS in “novice” and “proficient” surgeons. Only number of blinks per minute was significantly different between pupilometrics in the simulated and real tissue environments.
Conclusions
This study illustrates the value of eye tracking as an objective physiological tool in the robotic setting. Pupilometrics significantly correlate with established assessment methods and could be incorporated into robotic surgery assessments.
Eye metrics provide insight into surgical behaviour allowing differentiation of performance, however have not been used in robotic surgery. This study explores eye metrics of robotic surgeons in training in simulated and real tissue environments.
Methods
Following the Fundamentals of Robotic Surgery (FRS), training curriculum novice robotic surgeons were trained to expert‐derived benchmark proficiency using real tissue on the da Vinci Si and the da Vinci skills simulator (dVSS) simulator. Surgeons eye metrics were recorded using eye‐tracking glasses when both “novice” and “proficient” in both environments. Performance was assessed using Global Evaluative Assessment of Robotic skills (GEARS) and numeric psychomotor test score (NPMTS) scores.
Results
Significant (P ≤ .05) correlations were seen between pupil size, rate of change and entropy, and associated GEARS/NPMTS in “novice” and “proficient” surgeons. Only number of blinks per minute was significantly different between pupilometrics in the simulated and real tissue environments.
Conclusions
This study illustrates the value of eye tracking as an objective physiological tool in the robotic setting. Pupilometrics significantly correlate with established assessment methods and could be incorporated into robotic surgery assessments.
Date Issued
2020-04-01
Date Acceptance
2020-01-07
Citation
International Journal of Medical Robotics and Computer Assisted Surgery, 2020, 16 (2)
ISSN
1478-5951
Publisher
Wiley
Journal / Book Title
International Journal of Medical Robotics and Computer Assisted Surgery
Volume
16
Issue
2
Copyright Statement
© 2020 John Wiley & Sons, Ltd. This is the accepted version of the following article: Dilley, J, Singh, H, Pratt, P, Omar, I, Darzi, A, Mayer, E. Visual behaviour in robotic surgery—Demonstrating the validity of the simulated environment. Int J Med Robot. 2020;e2075, which has been published in final form at https://doi.org/10.1002/rcs.2075
Sponsor
Imperial College Healthcare NHS Trust
Imperial College Healthcare NHS Trust- BRC Funding
National Institute of Health Research
National Institute for Health Research
Identifier
https://onlinelibrary.wiley.com/doi/full/10.1002/rcs.2075
Grant Number
UR150
RDB04
NF SI 061710038
Subjects
Science & Technology
Life Sciences & Biomedicine
Surgery
eye metrics
robotic
simulation
training
SKILLS ASSESSMENT
ASSISTED SURGERY
ASSESSMENT-TOOL
EYE-TRACKING
VALIDATION
WORKLOAD
EXPERT
eye metrics
robotic
simulation
training
1103 Clinical Sciences
Surgery
Publication Status
Published
Coverage Spatial
Guildford, Surrey, UK
Article Number
ARTN e2075
Date Publish Online
2020-01-10