TY  - BOOK
AU  - Lazar, John F
AU  - Metchik, Ariana 
TI  - Objective performance indicators of cardiothoracic residents are associated with vascular injury during robotic-assisted lobectomy on porcine models
SN  - 1863-2483
KW  - *Internship and Residency
KW  - *Robotic Surgical Procedures
KW  - *Surgeons
KW  - *Thoracic Surgical Procedures
KW  - *Vascular System Injuries
KW  - Animals
KW  - Clinical Competence
KW  - Humans
KW  - Pilot Projects
KW  - Robotic Surgical Procedures/mt [Methods]
KW  - Swine
KW  - Automated
KW  - MedStar Washington Hospital Center
KW  - MedStar General Surgery Residency
KW  - MedStar Georgetown University Hospital/MedStar Washington Hospital Center
KW  - Journal Article
N2  - 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. Copyright � 2022. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature
UR  - https://dx.doi.org/10.1007/s11701-022-01476-9
ER  -