Surgical process modelling: a review

PurposeSurgery is continuously subject to technological and medical innovations that are transforming daily surgical routines. In order to gain a better understanding and description of surgeries, the field of surgical process modelling (SPM) has recently emerged. The challenge is to support surgery through the quantitative analysis and understanding of operating room activities. Related surgical process models can then be introduced into a new generation of computer-assisted surgery systems.MethodsIn this paper, we present a review of the literature dealing with SPM. This methodological review was obtained from a search using Google Scholar on the specific keywords: “surgical process analysis”, “surgical process model” and “surgical workflow analysis”.ResultsThis paper gives an overview of current approaches in the field that study the procedural aspects of surgery. We propose a classification of the domain that helps to summarise and describe the most important components of each paper we have reviewed, i.e., acquisition, modelling, analysis, application and validation/evaluation. These five aspects are presented independently along with an exhaustive list of their possible instantiations taken from the studied publications.ConclusionThis review allows a greater understanding of the SPM field to be gained and introduces future related prospects.

[1]  Pierre Jannin,et al.  Decision Making During Preoperative Surgical Planning , 2009, Hum. Factors.

[2]  Eduard Petlenkov,et al.  Recognition of the surgeon's motions during endoscopic operation by statistics based algorithm and n , 2008 .

[3]  Gero Strauß,et al.  Research Paper: Validation of Knowledge Acquisition for Surgical Process Models , 2009, J. Am. Medical Informatics Assoc..

[4]  Blake Hannaford,et al.  OBJECTIVE EVALUATION OF LAPAROSCOPIC SURGICAL SKILLS USING HIDDEN MARKOV MODELS BASED ON HAPTIC INFORMATION AND TOOL/TISSUE INTERACTIONS , 2000 .

[5]  Stephen B. Johnson,et al.  Conceptual knowledge acquisition in biomedicine: A methodological review , 2007, J. Biomed. Informatics.

[6]  A. Darzi,et al.  Skills assessment of surgeons. , 2002, Surgery.

[7]  P. Jannin,et al.  Model of Surgical Procedures for Multimodal Image-Guided Neurosurgery , 2003, Computer aided surgery : official journal of the International Society for Computer Aided Surgery.

[8]  Yan Xiao,et al.  Making Management Decisions on the Day of Surgery Based on Operating Room Efficiency and Patient Waiting Times , 2004, Anesthesiology.

[9]  F H Edwards,et al.  Use of a Bayesian statistical model for risk assessment in coronary artery surgery. , 1988, The Annals of thoracic surgery.

[10]  Rüdiger Dillmann,et al.  Knowledge-Based Situation Interpretation for Context-Aware Augmented Reality in Dental Implant Surgery , 2010, MIAR.

[11]  C. Taylor,et al.  Predictive medicine: computational techniques in therapeutic decision-making. , 1999, Computer aided surgery : official journal of the International Society for Computer Aided Surgery.

[12]  Darius Burschka,et al.  Synchronized Multimodal Recording System for Laparoscopic Minimally Invasive Surgeries , 2009 .

[13]  Thomas Neumuth,et al.  Online recognition of surgical instruments by information fusion , 2012, International Journal of Computer Assisted Radiology and Surgery.

[14]  Guang-Zhong Yang,et al.  Eye-Gaze Driven Surgical Workflow Segmentation , 2007, MICCAI.

[15]  Nassir Navab,et al.  Statistical modeling and recognition of surgical workflow , 2012, Medical Image Anal..

[16]  Nassir Navab,et al.  Synchronizing 3D movements for quantitative comparison and simultaneous visualization of actions , 2005, Fourth IEEE and ACM International Symposium on Mixed and Augmented Reality (ISMAR'05).

[17]  Uwe G. Kühnapfel,et al.  Endoscopic surgery training using virtual reality and deformable tissue simulation , 2000, Computers & graphics.

[18]  Henry C. Lin,et al.  Review of methods for objective surgical skill evaluation , 2011, Surgical Endoscopy.

[19]  Nathaniel Palmer,et al.  Workflow Management Coalition , 2009, Encyclopedia of Database Systems.

[20]  A F Merry,et al.  TADAA: Towards Automated Detection of Anaesthetic Activity. , 2011, Methods of information in medicine.

[21]  M. Frecker,et al.  Sequence and task analysis of instrument use in common laparoscopic procedures , 2002, Surgical Endoscopy And Other Interventional Techniques.

[22]  Vimla L. Patel,et al.  Review: A Primer on Aspects of Cognition for Medical Informatics , 2001, J. Am. Medical Informatics Assoc..

[23]  Elizabeth Manias,et al.  Governing time in operating rooms. , 2006, Journal of clinical nursing.

[24]  Peter Fu-Ming Hu,et al.  Real-Time Identification of Operating Room State from Video , 2007, AAAI.

[25]  F. Gebhard,et al.  OP-Organisation an einer Klinik der Maximalversorgung , 2006 .

[26]  Henry C. Lin,et al.  Towards automatic skill evaluation: Detection and segmentation of robot-assisted surgical motions , 2006, Computer aided surgery : official journal of the International Society for Computer Aided Surgery.

[27]  Nassir Navab,et al.  Workflow mining for visualization and analysis of surgeries , 2008, International Journal of Computer Assisted Radiology and Surgery.

[28]  Gero Strauß,et al.  Workflow analysis for mechatronic and imaging assistance in head surgery , 2004, CARS.

[29]  Nassir Navab,et al.  Motif Discovery in OR Sensor Data with Application to Surgical Workflow Analysis and Activity Detection , 2009 .

[30]  F Dexter,et al.  Mediated Interruptions of Anaesthesia Providers using Predictions of Workload from Anaesthesia Information Management System Data , 2012, Anaesthesia and intensive care.

[31]  Zhibin Jiang,et al.  A Surgical Management Information System Driven by Workflow , 2006, 2006 IEEE International Conference on Service Operations and Logistics, and Informatics.

[32]  Alex Macario,et al.  The drive for operating room efficiency will increase quality of patient care , 2006, Current opinion in anaesthesiology.

[33]  T. Langø,et al.  An Experimental Operating Room Project for Advanced Laparoscopic Surgery , 2004, Seminars in laparoscopic surgery.

[34]  G.D. Hager,et al.  Towards “real-time” tool-tissue interaction detection in robotically assisted laparoscopy , 2008, 2008 2nd IEEE RAS & EMBS International Conference on Biomedical Robotics and Biomechatronics.

[35]  Heinz Wörn,et al.  Operation planning of robot supported surgical interventions , 2000, Proceedings. 2000 IEEE/RSJ International Conference on Intelligent Robots and Systems (IROS 2000) (Cat. No.00CH37113).

[36]  Jesús Favela,et al.  Activity Recognition for the Smart Hospital , 2008, IEEE Intelligent Systems.

[37]  R. M. Satava,et al.  Metrics for objective Assessment , 2003, Surgical Endoscopy And Other Interventional Techniques.

[38]  S Riedl,et al.  [Modern operating room management in the workflow of surgery. Spectrum of tasks and challenges of the future]. , 2003, Der Anaesthesist.

[39]  A. Park,et al.  Advanced Devices for the Operating Room of the Future , 2003, Seminars in laparoscopic surgery.

[40]  A. Darzi,et al.  Measurement of Surgical Dexterity Using Motion Analysis of Simple Bench Tasks , 2003, World Journal of Surgery.

[41]  Bernard Gibaud,et al.  Design of a neurosurgical procedure model for multimodal image-guided surgery , 2001, CARS.

[42]  Pierre Jannin,et al.  Automatic knowledge-based recognition of low-level tasks in ophthalmological procedures , 2012, International Journal of Computer Assisted Radiology and Surgery.

[43]  J. Ledolter,et al.  Automatic Updating of Times Remaining in Surgical Cases Using Bayesian Analysis of Historical Case Duration Data and “Instant Messaging” Updates from Anesthesia Providers , 2009, Anesthesia and analgesia.

[44]  E C Coles,et al.  An evaluation of automatic coding of surgical pathology reports. , 1976, Journal of clinical pathology.

[45]  Blake Hannaford,et al.  Generalized approach for modeling minimally invasive surgery as a stochastic process using a discrete Markov model , 2006, IEEE Transactions on Biomedical Engineering.

[46]  A. Schleppers,et al.  Optimised workflow and organisation – from the point of view of an anaesthesiology department , 2003, Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy.

[47]  Gregory D. Hager,et al.  Task modeling and specification for modular sensory based human-machine cooperative systems , 2003, IROS.

[48]  Jenny Dankelman,et al.  Discovery of high-level tasks in the operating room , 2011, J. Biomed. Informatics.

[49]  Timothy W. Finin,et al.  A Pervasive Computing System for the Operating Room of the Future , 2007, Mob. Networks Appl..

[50]  Stefanie Speidel,et al.  MEDIASSIST: medical assistance for intraoperative skill transfer in minimally invasive surgery using augmented reality , 2007, SPIE Medical Imaging.

[51]  Walter Daelemans,et al.  Automatic discovery of workflow models from hospital data , 2001 .

[52]  René Vidal,et al.  Surgical Gesture Classification from Video Data , 2012, MICCAI.

[53]  Rüdiger Dillmann,et al.  Recognition of risk situations based on endoscopic instrument tracking and knowledge based situation modeling , 2008, SPIE Medical Imaging.

[54]  Evert de Jonge,et al.  Prognostic Bayesian networks: II: An application in the domain of cardiac surgery , 2007, J. Biomed. Informatics.

[55]  F H Edwards,et al.  1988: use of a Bayesian statistical model for risk assessment in coronary artery surgery. Updated in 1995. , 1995, The Annals of thoracic surgery.

[56]  Ricky K. Taira,et al.  Generating Models of Surgical Procedures using UMLS Concepts and Multiple Sequence Alignment , 2005, AMIA.

[57]  Pierre Jannin,et al.  A Framework for the Recognition of High-Level Surgical Tasks From Video Images for Cataract Surgeries , 2012, IEEE Transactions on Biomedical Engineering.

[58]  B. Hannaford,et al.  Task decomposition of laparoscopic surgery for objective evaluation of surgical residents' learning curve using hidden Markov model. , 2002, Computer aided surgery : official journal of the International Society for Computer Aided Surgery.

[59]  Guang-Zhong Yang,et al.  An eye-hand data fusion framework for pervasive sensing of surgical activities , 2012, Pattern Recognit..

[60]  Marie T. Egan,et al.  Deliberate Perioperative Systems Design Improves Operating Room Throughput , 2005, Anesthesiology.

[61]  Nassir Navab,et al.  Automatic feature generation in endoscopic images , 2008, International Journal of Computer Assisted Radiology and Surgery.

[62]  Fernando Bello,et al.  Real-time synchronization of kinematic and video data for the comprehensive assessment of surgical skills. , 2004, Studies in health technology and informatics.

[63]  Warren S. Sandberg,et al.  A computerized perioperative data integration and display system , 2007, International Journal of Computer Assisted Radiology and Surgery.

[64]  Franklin Dexter,et al.  Explanation for the Near-Constant Mean Time Remaining in Surgical Cases Exceeding Their Estimated Duration, Necessary for Appropriate Display on Electronic White Boards , 2013, Anesthesia and analgesia.

[65]  Thomas Neumuth,et al.  Linking Top-Level Ontologies and Surgical Workflows , 2006 .

[66]  Yan Xiao,et al.  Advanced Visualization Platform for Surgical Operating Room Coordination: Distributed Video Board System , 2006, Surgical innovation.

[67]  E. Maier New Frontiers in Artificial Intelligence , 2009 .

[68]  C A Grimbergen,et al.  Quantitative standardised analysis of advanced laparoscopic surgical procedures. , 1995, Endoscopic surgery and allied technologies.

[69]  Warren S. Sandberg,et al.  Does Parallel Workflow Impact Anesthesia Quality? , 2005, AMIA.

[70]  R. Flin,et al.  Non-technical skills for surgeons in the operating room: a review of the literature. , 2006, Surgery.

[71]  C A Grimbergen,et al.  Comparison of efficiencies of three techniques for colon surgery. , 2000, Journal of laparoendoscopic & advanced surgical techniques. Part A.

[72]  R. Bucholz,et al.  The operating room of the future. , 2004, Clinical neurosurgery.

[73]  Hiroshi Iseki,et al.  Video Information Management System for Information Guided Neurosurgery , 2011, ACCAS.

[74]  Jenny Dankelman,et al.  Analysis of the quality and efficiency in learning laparoscopic skills , 2009, Surgical Endoscopy.

[75]  L. MacKenzie,et al.  Hierarchical decomposition of laparoscopic surgery: a human factors approach to investigating the operating room environment , 2001, Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy.

[76]  Guang-Zhong Yang,et al.  Episode Classification for the Analysis of Tissue/Instrument Interaction with Multiple Visual Cues , 2003, MICCAI.

[77]  D. H. Mellor,et al.  Real time , 1981 .

[78]  Pierre Jannin,et al.  Surgical models for computer-assisted neurosurgery , 2007, NeuroImage.

[79]  Yan Xiao,et al.  An Algorithm for Processing Vital Sign Monitoring Data to Remotely Identify Operating Room Occupancy in Real-Time , 2005, Anesthesia and analgesia.

[80]  Thomas Neumuth,et al.  Similarity metrics for surgical process models , 2012, Artif. Intell. Medicine.

[81]  Nassir Navab,et al.  On-line Recognition of Surgical Activity for Monitoring in the Operating Room , 2008, AAAI.

[82]  Mukul Mukherjee,et al.  Medicine Meets Virtual Reality 14 , 2005 .

[83]  Thomas Neumuth,et al.  Visualization Options for Surgical Workflows , 2006 .

[84]  Shahram Payandeh,et al.  Task and Motion Analyses in Endoscopic Surgery , 1996, Dynamic Systems and Control.

[85]  Shahram Payandeh,et al.  On defining metrics for assessing laparoscopic surgical skills in a virtual training environment. , 2002, Studies in health technology and informatics.

[86]  Germain Forestier,et al.  Classification of surgical processes using dynamic time warping , 2012, J. Biomed. Informatics.

[87]  E. C. Marshall,et al.  A Bayesian hierarchical approach to comparative audit for carotid surgery. , 2002, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery.

[88]  P S White,et al.  Using human reliability analysis to detect surgical error in endoscopic DCR surgery. , 2003, Clinical otolaryngology and allied sciences.

[89]  Ken Masamune,et al.  Scrub nurse robot system-intraoperative motion analysis of a scrub nurse and timed-automata-based model for surgery , 2005, IEEE Transactions on Industrial Electronics.

[90]  Matthew B. Weinger,et al.  An Objective Methodology for Task Analysis and Workload Assessment in Anesthesia Providers , 1994, Anesthesiology.

[91]  K. Decker,et al.  Ergonomics in the operating room – from the anesthesiologist's point of view , 2003, Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy.

[92]  C G Cao,et al.  Gaze patterns in laparoscopic surgery. , 1999, Studies in health technology and informatics.

[93]  Eduard Petlenkov,et al.  Recognition of the Surgeon's Motions During Endoscopic Operation by Statistics Based Algorithm and Neural Networks Based ANARX Models , 2008 .

[94]  Dong-Soo Kwon,et al.  Surgery Task Model for Intelligent Interaction between Surgeon and Laparoscopic Assistant Robot , 2007 .

[95]  J Rosen,et al.  Objective laparoscopic skills assessments of surgical residents using Hidden Markov Models based on haptic information and tool/tissue interactions. , 2001, Studies in health technology and informatics.

[96]  Rhona Flin,et al.  How do surgeons make intraoperative decisions? , 2007, Quality and Safety in Health Care.

[97]  Kevin Cleary,et al.  OR 2020: the operating room of the future. , 2004, Journal of laparoendoscopic & advanced surgical techniques. Part A.

[98]  A Winter,et al.  Modeling Hospital Information Systems (Part 2): using the 3LGM2 tool for modeling patient record management. , 2004, Methods of information in medicine.

[99]  Nassir Navab,et al.  Recovery of Surgical Workflow: a Model-based Approach , 2007 .

[100]  T. Neumuth,et al.  Recording of Surgical Processes: A Study Comparing Senior and Junior Neurosurgeons During Lumbar Disc Herniation Surgery , 2010, Neurosurgery.

[101]  A Winter,et al.  Modeling Hospital Information Systems (Part 1): The Revised Three-layer Graph-based Meta Model 3LGM2 , 2003, Methods of Information in Medicine.

[102]  Pierre Jannin,et al.  Model for defining and reporting reference-based validation protocols in medical image processing , 2006, International Journal of Computer Assisted Radiology and Surgery.

[103]  Luís A. Castro,et al.  Activity Recognition for Context-aware Hospital Applications: Issues and Opportunities for the Deployment of Pervasive Networks , 2007, Mob. Networks Appl..

[104]  Nassir Navab,et al.  Recovery of Surgical Workflow Without Explicit Models , 2006, MICCAI.

[105]  T. Neumuth,et al.  Structured recording of intraoperative surgical workflows , 2006, SPIE Medical Imaging.

[106]  T Neumuth,et al.  Surgical workflow management schemata for cataract procedures. process model-based design and validation of workflow schemata. , 2012, Methods of information in medicine.

[107]  Ken Masamune,et al.  Development of Scrub Nurse Robot (SNR) systems for endoscopic and laparoscopic surgery , 2010, 2010 International Symposium on Micro-NanoMechatronics and Human Science.

[108]  Yasuo Sakurai,et al.  Surgical Workflow Monitoring Based on Trajectory Data Mining , 2010, JSAI-isAI Workshops.

[109]  P. Barbini,et al.  A multivariate Bayesian model for assessing morbidity after coronary artery surgery , 2006, Critical care.

[110]  Stefanie Speidel,et al.  Automatic classification of minimally invasive instruments based on endoscopic image sequences , 2009, Medical Imaging.

[111]  Christos Trantakis,et al.  ENT-surgical workflow as an instrument to assess the efficiency of technological developments in medicine , 2005 .

[112]  Randolph A. Miller,et al.  Review Paper: Interface Terminologies: Facilitating Direct Entry of Clinical Data into Electronic Health Record Systems , 2006, J. Am. Medical Informatics Assoc..