Examining surgeon’s eye-hand coordination during microsurgery

Jonathan Chainey

June 2020. University of Alberta ERA (Educational Research Archive).

DOI: https://doi.org/10.7939/r3-351b-8q80


Surgical simulation is now an essential component of surgical education and is now accepted as a valid tool for improving the skills of surgeons. Ultimately, this result in better outcome and patient safety. To maximize the benefit of practicing in a surgical simulation environment, objective assessment of surgical skill is essential but remains difficult to achieve. Criteria-based evaluations, where checklists and global rating scales are the two principal examples, are subject to inter-observer variability and subjective bias. Researchers believe that a more objective assessment of surgical skills should include force analysis, kinematic analysis and eye-tracking analysis. While these technologies have been used to a certain extent to describe surgeons’ eye-hand coordination in general surgery and laparoscopic surgery, little is known for microsurgery. This knowledge cannot be directly extrapolated to microsurgery as operating under a surgical microscope and looking at a magnified surgical field imply a different depth perception and adjustment of the eye-hand coordination. Aided by eye-tracking technology and video analysis to characterize surgeon’s movements, this thesis explored the acquisition of eye-hand coordination of microsurgeons. Specifically, we use these methods to detect the differences between expert and novice microsurgeons while they were performing three distinct surgical tasks under the microscope. Ultimately, these findings can be used to objectively assess the level of expertise of microsurgeons. The thesis concludes with a summary of findings and surgical education applications at this point. A brief discussion about future works is also present and these new studies would help to reinforce the importance of characterizing expert surgeons’ gaze behavior as it might lead to gaze training and facilitate skills learning.