The Effect of Expertise on Gaze Behaviour in Laparoscopic Cholecystectomy

Laparoscopic skills vary with experience and training of surgeons. The complexity of laparoscopic surgeries affects the cognitive resources of surgeons significantly and leads to many biliary injuries during surgeries. Assuming that experts are more focused, we investigated how the skill level of surgeons during live surgery is reflected through eye metrics. Throughout the study, we used five eye movement metrics classified under saccadic, fixations and pupillary metrics. Forty-two laparoscopic surgeries have been conducted with four surgeons belonging to three expertise levels (novice, semi-expert and expert) from which thirty-eight surgeries were considered in the study. With the use of mean, standard deviation and ANOVA test we found three reliable metrics which we can use to differentiate the skill levels during live surgeries.

[1]  David Crundall,et al.  Driver's visual attention as a function of driving experience and visibility. Using a driving simulator to explore drivers' eye movements in day, night and rain driving. , 2010, Accident; analysis and prevention.

[2]  Katarzyna Harezlak,et al.  Application of eye tracking in medicine: A survey, research issues and challenges , 2017, Comput. Medical Imaging Graph..

[3]  K. A. Ericsson,et al.  An expert‐performance perspective of research on medical expertise: the study of clinical performance , 2007, Medical education.

[4]  Martin Raubal,et al.  The Index of Pupillary Activity: Measuring Cognitive Load vis-à-vis Task Difficulty with Pupil Oscillation , 2018, CHI.

[5]  N. Charness,et al.  The perceptual aspect of skilled performance in chess: Evidence from eye movements , 2001, Memory & cognition.

[6]  B. Velichkovsky,et al.  Time course of information processing during scene perception: The relationship between saccade amplitude and fixation duration , 2005 .

[7]  Kevin W. Eva,et al.  The Cambridge Handbook of Expertise and Expert Performance: Expertise in Medicine and Surgery , 2006 .

[8]  Magdalena Borys,et al.  Eye-tracking metrics in perception and visual attention research , 2017 .

[9]  Riaz Agha,et al.  Does Laparoscopic Surgery Spell the end of the Open Surgeon? , 2003 .

[10]  Jan-Louis Kruger,et al.  Measuring the impact of subtitles on cognitive load: eye tracking and dynamic audiovisual texts , 2013, ETSA '13.

[11]  W. Al-Kubati.  Bile Duct Injuries Following Laparoscopic Cholecystectomy: A Clinical Study , 2010, Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association.

[12]  T. Crawford,et al.  How do radiologists do it? The influence of experience and training on searching for chest nodules. , 2006 .

[13]  Raymond Bertram,et al.  The Effect of Expertise on Eye Movement Behaviour in Medical Image Perception , 2013, PloS one.

[14]  Françoise Vitu,et al.  Word skipping: Implications for theories of eye movement control in reading , 1998 .

[15]  E. Krupinski,et al.  Eye-movement study and human performance using telepathology virtual slides: implications for medical education and differences with experience. , 2006, Human pathology.