Dustin Baker, MD1, Jacquelyn Pastewski, MD1, Amy Somerset, MD1, Kelsey Leonard2, Victoria Roach, PhD2, Kathryn Ziegler, MD1, Pavan Brahmamdam, MD1. 1Beaumont Health, Department of Surgery, Royal Oak, MI, USA, 2Oakland University William Beaumont School of Medicine, Rochester, MI, USA
Introduction: Using motion analysis, we aim to identify differences between junior and senior residents performing the laparoscopic peg transfer task, and the impact of a distracting secondary task on performance. Motion analysis is able to discriminate between expert and novice laparoscopic surgeons, but has not been used to illustrate motion patterns unique to surgical residents at different stages of training.
Methods: General Surgery residents at our institution were asked to perform the laparoscopic peg transfer task on a simulator equipped with a motion tracker. They were also asked to perform the simulated task while completing a secondary task (simple verbal arithmetic). The velocity and acceleration of movement in three degrees of freedom – pitch, yaw, and roll – were measured during task completion. The number of extreme events, defined as velocity or acceleration exceeding 1 SD above or below the mean, were tabulated. The performance of junior residents (PGY 1-2, n=14) was compared to senior residents (PGY 3-6, n=23) using student's t-test. SPSS 25 (IBM) was used for all statistics.
Results: Average task completion time was equivalent between the groups (junior: 84.5 vs. senior: 71.1s, p=0.1). With the addition of the secondary task, the average task completion time in the junior group significantly improved (84.5 vs. 75.2s, p=0.04) but was not significantly different from the senior group, (75.2 vs. 68.3s, p=0.31). The junior group answered more arithmetic questions (57.90 vs. 46.0, p=.03) with greater accuracy (57.6% vs. 45.8%, p=.03) than the senior group.
In the motion analysis of peg transfer task alone, the senior group executed significantly fewer extreme motion events specific to acceleration in pitch, (16.63 vs. 20.69, p=0.04). The senior group was found to execute more extreme motion events specific to velocity in roll, (16.14 vs. 15.11, p=0.038). In the secondary task condition, the senior group had fewer extreme acceleration events specific to pitch, (14.69 vs. 22.22, p<.001). There were no differences within groups regarding number of extreme events for each motion parameter with addition of a secondary task.
Conclusion: Motion analysis identified that senior residents execute fewer extreme acceleration events specific to pitch, which corresponds to motion in the vertical plane. This was true even when a secondary task was added. This suggests that senior residents execute movements more smoothly during peg transfer, relative to junior residents, even when task completion time is equivalent. Motion analysis may prove useful for real-time feedback during laparoscopic skill acquisition.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95015
Program Number: P399
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster