Developing a longitudinal database of surgical skills performance for practicing surgeons: A formal feasibility and acceptance inquiry

Background: The COVID-19 (SARS-COV-2) pandemic has brought unprecedented challenges to the health care system and education models. The reduction in case volume, transition to remote learning, lack of sports coverage opportunities, and decreased clinical interactions have had an immediate effect on orthopaedic sports medicine fellowship programs. Purpose/Hypothesis: Our purpose was to gauge the response to the pandemic from a sports medicine fellowship education perspective. We hypothesized that (1) the COVID-19 pandemic has caused a significant change in training programs, (2) in-person surgical skills training and didactic learning would be substituted with virtual learning, and (3) hands-on surgical training and case numbers would decrease and the percentage of fellows graduating with skill levels commensurate with graduation would decrease. Study Design: Cross-sectional study. Methods: In May 2020, a survey was sent to the fellowship directors of all 90 orthopaedic sports medicine fellowships accredited by the Accreditation Council for Graduate Medical Education; it included questions on program characteristics, educational lectures, and surgical skills. A total of 37 completed surveys (41%) were returned, all of which were deidentified. Responses were compiled and saved on a closed, protected institutional server. Results: In a majority of responding programs (89%), fellows continued to participate in the operating room. Fellows continued with in-person clinical visits in 65% of programs, while 51% had their fellows participate in telehealth visits. Fellows were “redeployed” to help triage and assist with off-service needs in 21% of programs compared with 65% of resident programs having residents rotate off service. Regarding virtual education, 78% of programs have used or are planning to use platforms offered by medical societies, and 49% have used or are planning to use third-party independent education platforms. Of the 37 programs, 30 reported no in-person lectures or meetings, and there was a sharp decline in the number of programs participating in cadaver laboratories (n = 10; 27%) and industry courses (n = 6; 16%). Conclusion: Virtual didactic and surgical education and training as well as telehealth will play a larger role in the coming year than in the past. There are effects to fellows’ exposure to sports coverage and employment opportunities. The biggest challenge will be how to maintain the element of human interaction and connect with patients and trainees at a time when social distancing is needed to curb the spread of COVID-19.

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Surgery to relieve nasal obstruction: outcome for 366 patients operated on by one senior surgeon

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-021-06696-7 ◽

2021 ◽

Author(s):

Lars Aksel Pedersen ◽

S. Dölvik ◽

K. Holmberg ◽

C. Ahlström Emanuelsson ◽

H. Johansson ◽

...

Keyword(s):

Beneficial Effect ◽

Nasal Obstruction ◽

General Health ◽

Surgical Skills ◽

Nasal Endoscopy ◽

Experienced Surgeon ◽

Senior Surgeon ◽

Significant Difference ◽

Before And After ◽

The Mean

Abstract Background Studies of patient-rated outcome in septoplasty and turbinoplasty most frequently involve several surgeons with varying surgical skills, techniques and experience. The aim of the present study was to evaluate outcome based on one experienced surgeon. Methods Three hundred and sixty-six consecutive patients referred for nasal obstruction were included. All the patients were examined with nasal endoscopy before and after decongestion, they filled out a nose VAS and rated their overall general health before and three to six months after surgery. The patients underwent septoplasty, septoplasty plus turbinoplasty or turbinoplasty. Results The mean nose VAS for nasal obstruction (0–100) preoperatively was 64.7 for all patients. Patients undergoing septoplasty (n = 159) were younger than patients undergoing septoplasty + turbinoplasty (n = 79) or patients undergoing turbinoplasty alone (n = 128). The nose VAS for nasal obstruction improved significantly in all three groups and 25% had a normal nose VAS after surgery in the septoplasty and septoplasty + turbinoplasty groups compared to only 8% in the turbinoplasty alone group. There was no significant difference in the improvement in nasal obstruction between septoplasty and septoplasty + turbinoplasty, but the septoplasty + turbinoplasty group experienced a significantly greater improvement in general health. Conclusions In 366 patients operated on by one experienced surgeon, septoplasty and septoplasty + turbinoplasty were more effective at relieving nasal obstruction than turbinoplasty alone. Septoplasty + turbinoplasty resulted in a greater improvement in general health than septoplasty alone, despite the same improvement in nasal obstruction, indicating a beneficial effect of additional turbinoplasty in septoplasty.

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934 Remote one-to-one virtual surgical skills training: Evolving the delivery of operative skills training in the UK

British Journal of Surgery ◽

10.1093/bjs/znab134.178 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

Christian Asher ◽

Ibrahim Ibrahim ◽

Eyfrossini Katsarma

Keyword(s):

Surgical Training ◽

Wound Closure ◽

Cost Effective ◽

Skills Training ◽

Training Programme ◽

Surgical Skills ◽

Wound Closure Techniques ◽

Surgical Skills Training ◽

Speciality Training ◽

One To One

Abstract Introduction COVID-19 has had an unprecedented effect on surgical training, including prerequisite entry-level courses to speciality training. We describe the implementation of a virtual, one-to-one training programme aimed at the acquisition and retention of operative skills. Methods Enrolment commenced 8th May 2020 for wound closure techniques or an extended programme including tendon repairs, delivered by Specialist Registrars in Plastic Surgery using Zoom® (v. 5.0.5) via mobile device. Participant feedback was collected retrospectively using a 5-point scale following course completion. Results 5 participants completed the wound closure programme, and 3 the extended programme, over an average of 5 weeks, with 2 sessions per week. 5 participants were male, 3 female and were of the following grades: 2 CT2, 4 FY2, 1 FY1 and 1 medical student. A total of 103.5 hours of training was recorded to 7 September 2020. Participants reported that all virtual skills taught were readily transferable to the theatre environment. Following the course, all participants felt confident to complete the skills learnt independently, rating the course as excellent. Conclusions The COVID-19 crisis has placed insurmountable obstacles in the face of surgical training. With further validation, we aim to develop surgical skills training with virtual, easily reproducible, cost-effective, trainee centred programmes.

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Automation of surgical skill assessment using a three-stage machine learning algorithm

Scientific Reports ◽

10.1038/s41598-021-84295-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Joël L. Lavanchy ◽

Joel Zindel ◽

Kadir Kirtac ◽

Isabell Twick ◽

Enes Hosgor ◽

...

Keyword(s):

Machine Learning ◽

Learning Algorithm ◽

Surgical Skills ◽

Adverse Outcomes ◽

Machine Learning Algorithms ◽

Surgical Instruments ◽

Skill Assessment ◽

Surgical Skill ◽

Surgical Skill Assessment ◽

Motion Features

AbstractSurgical skills are associated with clinical outcomes. To improve surgical skills and thereby reduce adverse outcomes, continuous surgical training and feedback is required. Currently, assessment of surgical skills is a manual and time-consuming process which is prone to subjective interpretation. This study aims to automate surgical skill assessment in laparoscopic cholecystectomy videos using machine learning algorithms. To address this, a three-stage machine learning method is proposed: first, a Convolutional Neural Network was trained to identify and localize surgical instruments. Second, motion features were extracted from the detected instrument localizations throughout time. Third, a linear regression model was trained based on the extracted motion features to predict surgical skills. This three-stage modeling approach achieved an accuracy of 87 ± 0.2% in distinguishing good versus poor surgical skill. While the technique cannot reliably quantify the degree of surgical skill yet it represents an important advance towards automation of surgical skill assessment.

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Study Links Surgical Skills to Fewer Long‐Term Colon Cancer Complications

Cancer ◽

10.1002/cncr.33605 ◽

2021 ◽

Vol 127 (10) ◽

pp. 1545-1546

Author(s):

Carrie Printz

Keyword(s):

Colon Cancer ◽

Surgical Skills ◽

Cancer Complications

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Crowd-Sourced Assessment of Surgical Skills of Urology Resident Applicants: Four-Year Experience

Journal of Surgical Education ◽

10.1016/j.jsurg.2021.05.005 ◽

2021 ◽

Author(s):

Rajiv Karani ◽

Shlomi Tapiero ◽

Francis A. Jefferson ◽

Simone Vernez ◽

Lillian Xie ◽

...

Keyword(s):

Surgical Skills

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A Novel Suture Training System for Open Surgery Replicating Procedures Performed by Experts Using Augmented Reality

Journal of Medical Systems ◽

10.1007/s10916-021-01735-6 ◽

2021 ◽

Vol 45 (5) ◽

Author(s):

Yuri Nagayo ◽

Toki Saito ◽

Hiroshi Oyama

Keyword(s):

Augmented Reality ◽

Motion Capture ◽

Open Surgery ◽

Three Dimensional ◽

Training System ◽

Surgical Skills ◽

Surgical Instruments ◽

Interrupted Suture ◽

Education Environment ◽

Surgical Field

AbstractThe surgical education environment has been changing significantly due to restricted work hours, limited resources, and increasing public concern for safety and quality, leading to the evolution of simulation-based training in surgery. Of the various simulators, low-fidelity simulators are widely used to practice surgical skills such as sutures because they are portable, inexpensive, and easy to use without requiring complicated settings. However, since low-fidelity simulators do not offer any teaching information, trainees do self-practice with them, referring to textbooks or videos, which are insufficient to learn open surgical procedures. This study aimed to develop a new suture training system for open surgery that provides trainees with the three-dimensional information of exemplary procedures performed by experts and allows them to observe and imitate the procedures during self-practice. The proposed system consists of a motion capture system of surgical instruments and a three-dimensional replication system of captured procedures on the surgical field. Motion capture of surgical instruments was achieved inexpensively by using cylindrical augmented reality (AR) markers, and replication of captured procedures was realized by visualizing them three-dimensionally at the same position and orientation as captured, using an AR device. For subcuticular interrupted suture, it was confirmed that the proposed system enabled users to observe experts’ procedures from any angle and imitate them by manipulating the actual surgical instruments during self-practice. We expect that this training system will contribute to developing a novel surgical training method that enables trainees to learn surgical skills by themselves in the absence of experts.

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