Original Article

International Journal of Computer Assisted Radiology and Surgery

, Volume 6, Issue 1, pp 59-71

First online:

Analysis of surgical intervention populations using generic surgical process models

  • Thomas NeumuthAffiliated withInnovation Center Computer Assisted Surgery (ICCAS), Universität Leipzig Email author 
  • , Pierre JanninAffiliated withFaculty of Medicine, INSERM, U746VisAGeS Unit/Project, INRIACNRS, UMR 6074, IRISA, University of Rennes I
  • , Juliane SchlombergAffiliated withDepartment of Ophthalmology, University Hospital Leipzig
  • , Jürgen MeixensbergerAffiliated withInnovation Center Computer Assisted Surgery (ICCAS), Universität LeipzigDepartment of Neurosurgery, Univeristy Hospital Leipzig
  • , Peter WiedemannAffiliated withDepartment of Ophthalmology, University Hospital Leipzig
  • , Oliver BurgertAffiliated withInnovation Center Computer Assisted Surgery (ICCAS), Universität Leipzig

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According to differences in patient characteristics, surgical performance, or used surgical technological resources, surgical interventions have high variability. No methods for the generation and comparison of statistical ‘mean’ surgical procedures are available. The convenience of these models is to provide increased evidence for clinical, technical, and administrative decision-making.


Based on several measurements of patient individual surgical treatments, we present a method of how to calculate a statistical ‘mean’ intervention model, called generic Surgical Process Model (gSPM), from a number of interventions. In a proof-of-concept study, we show how statistical ‘mean’ procedure courses can be computed and how differences between several of these models can be quantified. Patient individual surgical treatments of 102 cataract interventions from eye surgery were allocated to an ambulatory or inpatient sample, and the gSPMs for each of the samples were computed. Both treatment strategies are exemplary compared for the interventional phase Capsulorhexis.


Statistical differences between the gSPMs of ambulatory and inpatient procedures of performance times for surgical activities and activity sequences were identified. Furthermore, the work flow that corresponds to the general recommended clinical treatment was recovered out of the individual Surgical Process Models.


The computation of gSPMs is a new approach in medical engineering and medical informatics. It supports increased evidence, e.g. for the application of alternative surgical strategies, investments for surgical technology, optimization protocols, or surgical education. Furthermore, this may be applicable in more technical research fields, as well, such as the development of surgical workflow management systems for the operating room of the future.


Surgical workflow Surgical Process Model Health care evaluation mechanisms Cataract surgery