Analysis of surgical motions in minimally invasive surgery using complexity theory

Traditional Minimally Invasive Surgery (MIS) training paradigm in which interns and junior residents perform operations under the supervision of faculty surgeons lacks objective means of assessing surgical skills. This paper studies novel real–time measures that can dynamically quantify surgical motions. In this study, the proposed measures were tested through two phases of experimental study. In the first phase, ten volunteered subjects who have no prior experience of MIS completed three trials of a surgical exercise using a laparoscopic instrument on which a motion sensor was attached. In the second phase, an MIS surgeon performed three standard surgical exercises with five replications. Then, time–delay and Hurst exponent analysis were used to measure the degree of synchronisation in surgical motions. As the results, improvement in surgical motions was observed such that the range and thickness of time–delay plots are reduced while Hurst exponents increase, as the subjects gain experience.