Title: Recurrence quantification analysis for surgical motions in minimally invasive surgery

Authors: Mona Saffarzadeh; Sohyung Cho; Ikechukwu Ohu; Ahmed Zihni; Michael M. Awad

Addresses: Industrial and Manufacturing Engineering, Southern Illinois University, Edwardsville, IL 62026, USA ' Industrial and Manufacturing Engineering, Southern Illinois University, Edwardsville, IL 62026, USA ' Industrial Engineering, Gannon University, Pennsylvania, PA 16541, USA ' School of Medicine, Washington University in Saint Louis, Saint Louis, MO 63110, USA ' School of Medicine, Washington University in Saint Louis, Saint Louis, MO 63110, USA

Abstract: Minimally invasive surgical technique (MIS) is difficult to master due to its inherent complexity imposed by reduced work volume and limited flexibility in motions. In traditional MIS training, faculty surgeons evaluate junior surgeon's performance using subjective and resource-intensive methods lacking quantitative rigour. Although recent technological advancement in surgical education has enabled more objective and automated evaluation of surgical skill, most of measures are still task-specific and thus can be hardly generalised across different operations and platforms. Therefore, this research studies a novel framework for generalised performance measure based on the analysis of non-linear dynamics in surgical motions. Specifically, surgical motions are recorded using motion sensors attached on instruments during surgical exercises. Then, intensity of recurrences in the motion data is calculated and disorder index is computed using the intensity of recurrences. The test results have shown that disorder index values can be used to quantify surgical skill levels.

Keywords: complexity theory; disorder index; minimally invasive surgery; MIS; surgical motions; recurrence quantification; surgical education; surgical skills; performance measures; nonlinear dynamics; motion sensors; surgical training.

DOI: 10.1504/IJBET.2016.077181

International Journal of Biomedical Engineering and Technology, 2016 Vol.21 No.2, pp.159 - 175

Received: 24 Aug 2015
Accepted: 19 Oct 2015

Published online: 22 Jun 2016 *

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