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Evaluation of suturing performance in general surgery and ocular microsurgery by combining computer vision-based software and distributed fiber optic strain sensors: a proof-of-concept

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

Improper suturing may cause an inadequate wound healing process and wound dehiscence as well as infection and even graft rejection in case of corneal transplantation. Hence, training surgeons in correct suturing procedures and objectively assessing their surgical skills is desirable.

Methods

Two complementary methods for assessment of suturing skills in two medical fields (general surgery and ocular microsurgery) were demonstrated. Suturing quality is assessed by computer vision software. Evaluation of stitching flow of operation is based on measuring strain induced in an optical fiber that is placed in proximity to the wound and parallel thereto and is pressed and passed by wound stitches.

Results

Our software generated a score for suturing outcome in both general surgery and ocular microsurgery when the stitching was done on a patch. Every trainee received a score in the range 0–100 that describes his/her performance. Strain values were recognized when using a patch in general surgery and a rubber patch in ocular microsurgery, but were less distinct in (disqualified) human cornea.

Conclusions

We proved a concept of an objective scoring method (based on various image processing algorithms) for assessment of suturing performance. It was also shown that fiber optic strain sensors are sensitive to the flow of stitching operation on a patch but are less sensitive to the flow of stitching operation on a human cornea. By combining these two methods, we can comprehensively evaluate the suturing performance objectively.

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Acknowledgements

The authors thank Mr. Andreas Stern from Luna Innovations Ltd. and Mr. Larry Hagler from El-Gev Electronics Ltd., for their assistance in operating the ODiSI 6104.

Funding

This research did not receive any grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Author notes

  1. Yoav Nahum and Ronnie Tepper have contributed equally to this work.

Authors and Affiliations

  1. Department of Electrical Engineering, Faculty of Engineering, Holon Institute of Technology, Holon, Israel

    Amir Handelman & Refael Barkan

  2. Simultech Center for Medical Simulation, Clalit Health Services, Meir Hospital Medical Center, Kfar Saba, Israel

    Ronnie Tepper

  3. Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel

    Yariv Keshet, Eitan Livny & Yoav Nahum

  4. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Yariv Keshet, Eitan Livny, Yoav Nahum & Ronnie Tepper

Authors
  1. Amir Handelman
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  2. Yariv Keshet
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  3. Eitan Livny
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  4. Refael Barkan
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  5. Yoav Nahum
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Correspondence to Amir Handelman.

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Handelman, A., Keshet, Y., Livny, E. et al. Evaluation of suturing performance in general surgery and ocular microsurgery by combining computer vision-based software and distributed fiber optic strain sensors: a proof-of-concept. Int J CARS 15, 1359–1367 (2020). https://doi.org/10.1007/s11548-020-02187-y

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  • DOI: https://doi.org/10.1007/s11548-020-02187-y

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