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Devin CL, Gillani M, Shields MC, Eldredge K, Kucera W, Rupji M, Purvis LA, Paul Olson TJ, Liu Y, Jarc A, Rosen SA. Ratio of Economy of Motion: A New Objective Performance Indicator to Assign Consoles During Dual-Console Robotic Proctectomy. Am Surg 2023:31348231161767. [PMID: 36898676 DOI: 10.1177/00031348231161767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Abstract
BACKGROUND Our group investigates objective performance indicators (OPIs) to analyze robotic colorectal surgery. Analyses of OPI data are difficult in dual-console procedures (DCPs) as there is currently no reliable, efficient, or scalable technique to assign console-specific OPIs during a DCP. We developed and validated a novel metric to assign tasks to appropriate surgeons during DCPs. METHODS A colorectal surgeon and fellow reviewed 21 unedited, dual-console proctectomy videos with no information to identify the operating surgeons. The reviewers watched a small number of random tasks and assigned "attending" or "trainee" to each task. Based on this sampling, the remainder of task assignments for each procedure was extrapolated. In parallel, we applied our newly developed OPI, ratio of economy of motion (rEOM), to assign consoles. Results from the 2 methods were compared. RESULTS A total of 1811 individual surgical tasks were recorded during 21 proctectomy videos. A median of 6.5 random tasks (137 total) were reviewed during each video, and the remainder of task assignments were extrapolated based on the 7.6% of tasks audited. The task assignment agreement was 91.2% for video review vs rEOM, with rEOM providing ground truth. It took 2.5 hours to manually review video and assign tasks. Ratio of economy of motion task assignment was immediately available based on OPI recordings and automated calculation. DISCUSSION We developed and validated rEOM as an accurate, efficient, and scalable OPI to assign individual surgical tasks to appropriate surgeons during DCPs. This new resource will be useful to everyone involved in OPI research across all surgical specialties.
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Affiliation(s)
- Courtney L Devin
- Department of Surgery, 12239Emory University School of Medicine, Atlanta, GA, USA
| | - Mishal Gillani
- Department of Surgery, 12239Emory University School of Medicine, Atlanta, GA, USA
| | | | - Kyle Eldredge
- Department of Surgery, 12239Emory University School of Medicine, Atlanta, GA, USA
| | - Walter Kucera
- Department of Surgery, 12239Emory University School of Medicine, Atlanta, GA, USA
| | - Manali Rupji
- Biostatistics Shared Resource, Winship Cancer Institute, 1371Emory University, Atlanta, GA, USA
| | - Lilia A Purvis
- Research Division, 19727Intuitive Surgical, Norcross, GA, USA
| | | | - Yuan Liu
- Biostatistics Shared Resource, Winship Cancer Institute, 1371Emory University, Atlanta, GA, USA.,Department of Biostatistics and Bioinformatics, Rollins School of Public Health, 1371Emory University, Atlanta, GA, USA
| | - Anthony Jarc
- Research Division, 19727Intuitive Surgical, Norcross, GA, USA
| | - Seth A Rosen
- Department of Surgery, 12239Emory University School of Medicine, Atlanta, GA, USA
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