Desarrollo y validación de sistemas de seguimiento de instrumental laparasocópico para la evaluación objetiva de destrezas quirúrgicasMethods for laparoscopic instrument tracking and motion analysis for objective assessment of surgucal technical skills

Résumé

Minimally invasive surgery (MIS) has become in many surgical specialties and procedures the gold-standard choice due to its efficiency and benefits towards patient safety. However, the introduction of laparoscopic surgery has led to the need to develop new surgical skills different to the open surgery. Traditional subjective assessment methods of trainee are no longer adequate for surgical training. Reduced working hours and demands from surgeons and associations mean that more objective assessment tools that can accredit surgeons as technically competent are required. Within this context and taking into account the needs discussed above, we propose three novel motion analysis methods of real laparoscopic instruments as tools for MIS technical skills assessment in laparoscopic training. These methods are based on computer vision techniques attempting to not interfere with the laparoscopic training activity. They are shown in an evolutionary way from methods for exclusive use in a box trainer to solutions with the potential of being used in actual OR setting. The first method presents a tracking system of laparoscopic instruments based on stereoscopic vision techniques, which is installed inside a box trainer. The second method adapts a commercially available optical pose tracker for laparoscopic practice. Finally, the last method implements a video-based tracking method of laparoscopic instruments based on the endoscopic image as the source of information.