Beyond Efficiency: Surface Electromyography Enables Further Insights into the Surgical Movements of Urologists.

Journal: Journal of endourology
Published Date: Oct 1, 2022

Abstract

Surgical skill evaluation while performing minimally invasive surgeries is a highly complex task. It is important to objectively assess an individual's technical skills throughout surgical training to monitor progress and to intervene when skills are not commensurate with the year of training. The miniaturization of wireless wearable platforms integrated with sensor technology has made it possible to noninvasively assess muscle activations and movement variability during performance of minimally invasive surgical tasks. Our objective was to use electromyography (EMG) to deconstruct the motions of a surgeon during robotic suturing (RS) and distinguish quantifiable movements that characterize the skill of an experienced expert urologic surgeon from trainees. Three skill groups of participants, novice ( = 11), intermediate ( = 12), and expert ( = 3), were enrolled in the study. A total of 12 wireless wearable sensors consisting of surface EMGs and accelerometers were placed along upper extremity muscles to assess muscle activations and movement variability, respectively. Participants then performed a RS task. EMG-based parameters, total time, dominant frequency, and cumulative muscular workload, were significantly different across the three skill groups. We also found nonlinear movement variability parameters such as correlation dimension, Lyapunov exponent trended differently across the three skill groups. These findings suggest that economy of motion variables and nonlinear movement variabilities are affected by surgical experience level. Wearable sensor signal analysis could make it possible to objectively evaluate surgical skill level periodically throughout the residency training experience. Clinical Trial Registration Number: HS# 2018-4407.

Authors

  • Rahul Soangra
    Crean College of Health and Behavioral Sciences, Chapman University, Orange, CA 92866.
  • Pengbo Jiang
  • Daniel Haik
    Department of Urology, University of California, Irvine, Orange, California, USA.
  • Perry Xu
    Department of Urology, University of California, Irvine, Orange, California, USA.
  • Andrew Brevik
    Department of Urology, University of California, Irvine, Orange, California, USA.
  • Akhil Peta
    Department of Urology, University of California, Irvine, Orange, California, USA.
  • Shlomi Tapiero
    Department of Urology, University of California, Irvine, Orange, California, USA.
  • Jaime Landman
    University of California Irvine School of Medicine, Orange, CA, USA.
  • Emmanuel John
    Department of Physical Therapy, Crean College of Health and Behavioral Sciences, Chapman University, Orange, California, USA.
  • Ralph V Clayman
    Department of Urology, University of California, Irvine, Orange, California, USA.

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