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EVA: Laparoscopic Instrument Tracking Based on Endoscopic Video Analysis for Psychomotor Skills Assessment

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Abstract

Introduction

The EVA (Endoscopic Video Analysis) tracking system is a new system for extracting motions of laparoscopic instruments based on nonobtrusive video tracking. The feasibility of using EVA in laparoscopic settings has been tested in a box trainer setup.

Methods

EVA makes use of an algorithm that employs information of the laparoscopic instrument’s shaft edges in the image, the instrument’s insertion point, and the camera’s optical center to track the three-dimensional position of the instrument tip. A validation study of EVA comprised a comparison of the measurements achieved with EVA and the TrEndo tracking system. To this end, 42 participants (16 novices, 22 residents, and 4 experts) were asked to perform a peg transfer task in a box trainer. Ten motion-based metrics were used to assess their performance.

Results

Construct validation of the EVA has been obtained for seven motion-based metrics. Concurrent validation revealed that there is a strong correlation between the results obtained by EVA and the TrEndo for metrics, such as path length (ρ = 0.97), average speed (ρ = 0.94), or economy of volume (ρ = 0.85), proving the viability of EVA.

Conclusions

EVA has been successfully validated in a box trainer setup, showing the potential of endoscopic video analysis to assess laparoscopic psychomotor skills. The results encourage further implementation of video tracking in training setups and image-guided surgery.

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Acknowledgments

The authors thank all surgeons, residents, and medical students, who kindly volunteered and participated in the experimental trials, and staff of the skills laboratory of LUMC for providing the available working space.

Disclosures

Mr. Ignacio Oropesa receives funding from the FPU Program of the Spanish Ministry of Science and Innovation [AP2007-00465]. Dr. Patricia Sánchez-González, Dr. Francisco M. Sánchez-Margallo, and Prof. Enrique J. Gómez participate under funding of the CIBER-BBN research project THEMIS. Dr. Magdalena K. Chmarra participates under the Marie Curie ITN project IIIOS (Integrated Interventional Imaging Operating System) project 238802. Dr. Pablo Lamata, Mr. Álvaro Fernández, Mr. Juan A. Sánchez-Margallo, Dr. Frank Willem Jansen, and Prof. Jenny Dankelman have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Bioengineering and Telemedicine Centre (GBT), ETSI Telecomunicación, Universidad Politécnica de Madrid (UPM), Avda Complutense, 30, 28040, Madrid, Spain

    Ignacio Oropesa, Patricia Sánchez-González, Pablo Lamata, Álvaro Fernández & Enrique J. Gómez

  2. Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Poeta Mariano Esquillor s/n. 50018, Saragossa, Spain

    Ignacio Oropesa, Patricia Sánchez-González, Álvaro Fernández & Enrique J. Gómez

  3. Department of BioMechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering (3mE), Delft University of Technology, Mekelweg 2, 2628 CD, Delft, The Netherlands

    Magdalena K. Chmarra, Frank Willem Jansen & Jenny Dankelman

  4. Department of Gynecology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands

    Frank Willem Jansen

  5. Jesús Usón Minimally Invasive Surgery Centre, Carretera N-521, km 41.8, 10071, Cáceres, Spain

    Juan A. Sánchez-Margallo & Francisco M. Sánchez-Margallo

  6. Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway

    Magdalena K. Chmarra

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  1. Ignacio Oropesa
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  2. Patricia Sánchez-González
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  8. Jenny Dankelman
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  9. Francisco M. Sánchez-Margallo
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  10. Enrique J. Gómez
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Correspondence to Ignacio Oropesa.

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Oropesa, I., Sánchez-González, P., Chmarra, M.K. et al. EVA: Laparoscopic Instrument Tracking Based on Endoscopic Video Analysis for Psychomotor Skills Assessment. Surg Endosc 27, 1029–1039 (2013). https://doi.org/10.1007/s00464-012-2513-z

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  • DOI: https://doi.org/10.1007/s00464-012-2513-z

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