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An explainable machine learning method for assessing surgical skill in liposuction surgery

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

Abstract

Purpose

Surgical skill assessment has received growing interest in surgery training and quality control due to its essential role in competency assessment and trainee feedback. However, the current assessment methods rarely provide corresponding feedback guidance while giving ability evaluation. We aim to validate an explainable surgical skill assessment method that automatically evaluates the trainee performance of liposuction surgery and provides visual postoperative and real-time feedback.

Methods

In this study, machine learning using a model-agnostic interpretable method based on stroke segmentation was introduced to objectively evaluate surgical skills. We evaluated the method on liposuction surgery datasets that consisted of motion and force data for classification tasks.

Results

Our classifier achieved optimistic accuracy in clinical and imitation liposuction surgery models, ranging from 89 to 94%. With the help of SHapley Additive exPlanations (SHAP), we deeply explore the potential rules of liposuction operation between surgeons with variant experiences and provide real-time feedback based on the ML model to surgeons with undesirable skills.

Conclusion

Our results demonstrate the strong abilities of explainable machine learning methods in objective surgical skill assessment. We believe that the machine learning model based on interpretive methods proposed in this article can improve the evaluation and training of liposuction surgery and provide objective assessment and training guidance for other surgeries.

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Funding

Peking Union Medical College Graduate Student Innovation Fund (100232 01800402) and Capital’s Funds for Health Improvement and Research (2018–1-4041).

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Authors and Affiliations

  1. School of Biomedical Science and Medical Engineering, Beihang University, Beijing, China

    Sutuke Yibulayimu, Yanzhen Liu, Zhibin Sun & Yu Wang

  2. Center of Body Contouring and Liposuction Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

    Yuneng Wang, Haiyue Jiang & Facheng Li

Authors
  1. Sutuke Yibulayimu
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  2. Yuneng Wang
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  3. Yanzhen Liu
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  4. Zhibin Sun
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  5. Yu Wang
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  6. Haiyue Jiang
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  7. Facheng Li
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Corresponding author

Correspondence to Yu Wang.

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Conflict of Interest

The authors, Sutuke Yibulayimu, Yuneng Wang, Yanzhen Liu, Zhibin Sun, Yu Wang, Haiyue Jiang, Facheng Li, declare that they have no conflicts of interest.

Ethical approval

Ethical approval was given by the Medical Ethics Committee of Plastic Surgery Hospital, Chinese Academy of Medical Sciences (2018–52).

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Yibulayimu, S., Wang, Y., Liu, Y. et al. An explainable machine learning method for assessing surgical skill in liposuction surgery. Int J CARS 17, 2325–2336 (2022). https://doi.org/10.1007/s11548-022-02739-4

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  • DOI: https://doi.org/10.1007/s11548-022-02739-4

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