Revisiting sylvian fissure dissection - A preliminary investigation into surgical process modelling for evaluating surgical proficiency
Introduction: Understanding the factors that contribute to efficient surgical behaviour and the prevention of technical errors poses a significant challenge in neurosurgery. Current training curricula lack proficiency-centred training and objective tools to assess surgical performance, leading to co...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-01-01
|
| Series: | Brain and Spine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772529425001031 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849471639903797248 |
|---|---|
| author | Félix Buyck Jef Vandemeulebroucke Ine Dirks Jan Frederick Cornelius Johnny Duerinck Sebastien Froelich Henry Schroeder Wietse Geens Frederick Van Gestel Michaël Bruneau |
| author_facet | Félix Buyck Jef Vandemeulebroucke Ine Dirks Jan Frederick Cornelius Johnny Duerinck Sebastien Froelich Henry Schroeder Wietse Geens Frederick Van Gestel Michaël Bruneau |
| author_sort | Félix Buyck |
| collection | DOAJ |
| description | Introduction: Understanding the factors that contribute to efficient surgical behaviour and the prevention of technical errors poses a significant challenge in neurosurgery. Current training curricula lack proficiency-centred training and objective tools to assess surgical performance, leading to considerable variability in surgical competencies and practices among neurosurgeons. This study aims to evaluate the determinants of proficient surgical behaviour exhibited by expert surgeons, with the goal of establishing a set of surgical performance metrics serving as a foundation for objective assessment and benchmarking of surgical performance. Material and methods: Eight aneurysm clipping cases by three senior neurosurgeons were recorded via a surgical microscope. Surgeons' actions, workflow parameters, and adverse events during Sylvian fissure dissection were catalogued into Surgical Process Models (SPMs). Performance metrics were extracted, compared, and analysed using clustering analysis to assess proficiency differences. Results: 23 parameters were identified as potential metrics of surgical proficiency. Proficient surgeons exhibited predominant bimanual activity, optimal non-dominant hand use, a limited tool repertoire, minimal instrument changes, and efficient microscope use with minimal adjustments. Despite varying instrument and microscope usage, practitioners achieved consistent outcomes across metrics, indicating similar surgical proficiency. Discussion and conclusion: Findings illustrate that performance metrics derived from surgical video analysis can reliably contribute to the assessment of surgical skills. SPMs offer a structured understanding of the factors that contribute to surgical proficiency. This approach provides an optimal framework for objective assessment of performance metrics, demonstrating potential for automated and objective analysis of surgical performance. |
| format | Article |
| id | doaj-art-a5b3b59b00af49b7a0fdbdc434f37efd |
| institution | Kabale University |
| issn | 2772-5294 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brain and Spine |
| spelling | doaj-art-a5b3b59b00af49b7a0fdbdc434f37efd2025-08-20T03:24:45ZengElsevierBrain and Spine2772-52942025-01-01510428410.1016/j.bas.2025.104284Revisiting sylvian fissure dissection - A preliminary investigation into surgical process modelling for evaluating surgical proficiencyFélix Buyck0Jef Vandemeulebroucke1Ine Dirks2Jan Frederick Cornelius3Johnny Duerinck4Sebastien Froelich5Henry Schroeder6Wietse Geens7Frederick Van Gestel8Michaël Bruneau9Department of Neurosurgery, Universitair Ziekenhuis Brussel (UZ Brussel), 1090, Brussels, Belgium; Vrije Universiteit Brussel (VUB), Research group Center for Neurosciences (C4N-NEUR), 1090, Brussels, Belgium; Corresponding author. Department of Neurosurgery, Universitair Ziekenhuis Brussel (UZ Brussel), Laerbeeklaan 101, 1090, Brussels, Belgium.Vrije Universiteit Brussel (VUB), Department of Electronics and Informatics (ETRO), 1050, Brussels, Belgium; Department of Radiology, Universitair Ziekenhuis Brussel (UZ Brussel), 1090, Brussels, Belgium; Imec, 3001, Leuven, BelgiumVrije Universiteit Brussel (VUB), Department of Electronics and Informatics (ETRO), 1050, Brussels, BelgiumDepartment of Neurosurgery, Medical Faculty, Heinrich-Heine-University, 40225 Düsseldorf, GermanyDepartment of Neurosurgery, Universitair Ziekenhuis Brussel (UZ Brussel), 1090, Brussels, Belgium; Vrije Universiteit Brussel (VUB), Research group Center for Neurosciences (C4N-NEUR), 1090, Brussels, BelgiumDepartment of Neurosurgery, Lariboisière Hospital, 75010, Paris, FranceDepartment of Neurosurgery, Medicine Greifswald University, 17489, Greifswald, GermanyDepartment of Neurosurgery, Universitair Ziekenhuis Brussel (UZ Brussel), 1090, Brussels, Belgium; Vrije Universiteit Brussel (VUB), Research group Center for Neurosciences (C4N-NEUR), 1090, Brussels, BelgiumDepartment of Neurosurgery, Universitair Ziekenhuis Brussel (UZ Brussel), 1090, Brussels, Belgium; Vrije Universiteit Brussel (VUB), Research group Center for Neurosciences (C4N-NEUR), 1090, Brussels, BelgiumDepartment of Neurosurgery, Universitair Ziekenhuis Brussel (UZ Brussel), 1090, Brussels, Belgium; Vrije Universiteit Brussel (VUB), Research group Center for Neurosciences (C4N-NEUR), 1090, Brussels, BelgiumIntroduction: Understanding the factors that contribute to efficient surgical behaviour and the prevention of technical errors poses a significant challenge in neurosurgery. Current training curricula lack proficiency-centred training and objective tools to assess surgical performance, leading to considerable variability in surgical competencies and practices among neurosurgeons. This study aims to evaluate the determinants of proficient surgical behaviour exhibited by expert surgeons, with the goal of establishing a set of surgical performance metrics serving as a foundation for objective assessment and benchmarking of surgical performance. Material and methods: Eight aneurysm clipping cases by three senior neurosurgeons were recorded via a surgical microscope. Surgeons' actions, workflow parameters, and adverse events during Sylvian fissure dissection were catalogued into Surgical Process Models (SPMs). Performance metrics were extracted, compared, and analysed using clustering analysis to assess proficiency differences. Results: 23 parameters were identified as potential metrics of surgical proficiency. Proficient surgeons exhibited predominant bimanual activity, optimal non-dominant hand use, a limited tool repertoire, minimal instrument changes, and efficient microscope use with minimal adjustments. Despite varying instrument and microscope usage, practitioners achieved consistent outcomes across metrics, indicating similar surgical proficiency. Discussion and conclusion: Findings illustrate that performance metrics derived from surgical video analysis can reliably contribute to the assessment of surgical skills. SPMs offer a structured understanding of the factors that contribute to surgical proficiency. This approach provides an optimal framework for objective assessment of performance metrics, demonstrating potential for automated and objective analysis of surgical performance.http://www.sciencedirect.com/science/article/pii/S2772529425001031Surgical process modellingSkill assessmentSurgical video analysisSylvian fissure dissectionProficiency |
| spellingShingle | Félix Buyck Jef Vandemeulebroucke Ine Dirks Jan Frederick Cornelius Johnny Duerinck Sebastien Froelich Henry Schroeder Wietse Geens Frederick Van Gestel Michaël Bruneau Revisiting sylvian fissure dissection - A preliminary investigation into surgical process modelling for evaluating surgical proficiency Brain and Spine Surgical process modelling Skill assessment Surgical video analysis Sylvian fissure dissection Proficiency |
| title | Revisiting sylvian fissure dissection - A preliminary investigation into surgical process modelling for evaluating surgical proficiency |
| title_full | Revisiting sylvian fissure dissection - A preliminary investigation into surgical process modelling for evaluating surgical proficiency |
| title_fullStr | Revisiting sylvian fissure dissection - A preliminary investigation into surgical process modelling for evaluating surgical proficiency |
| title_full_unstemmed | Revisiting sylvian fissure dissection - A preliminary investigation into surgical process modelling for evaluating surgical proficiency |
| title_short | Revisiting sylvian fissure dissection - A preliminary investigation into surgical process modelling for evaluating surgical proficiency |
| title_sort | revisiting sylvian fissure dissection a preliminary investigation into surgical process modelling for evaluating surgical proficiency |
| topic | Surgical process modelling Skill assessment Surgical video analysis Sylvian fissure dissection Proficiency |
| url | http://www.sciencedirect.com/science/article/pii/S2772529425001031 |
| work_keys_str_mv | AT felixbuyck revisitingsylvianfissuredissectionapreliminaryinvestigationintosurgicalprocessmodellingforevaluatingsurgicalproficiency AT jefvandemeulebroucke revisitingsylvianfissuredissectionapreliminaryinvestigationintosurgicalprocessmodellingforevaluatingsurgicalproficiency AT inedirks revisitingsylvianfissuredissectionapreliminaryinvestigationintosurgicalprocessmodellingforevaluatingsurgicalproficiency AT janfrederickcornelius revisitingsylvianfissuredissectionapreliminaryinvestigationintosurgicalprocessmodellingforevaluatingsurgicalproficiency AT johnnyduerinck revisitingsylvianfissuredissectionapreliminaryinvestigationintosurgicalprocessmodellingforevaluatingsurgicalproficiency AT sebastienfroelich revisitingsylvianfissuredissectionapreliminaryinvestigationintosurgicalprocessmodellingforevaluatingsurgicalproficiency AT henryschroeder revisitingsylvianfissuredissectionapreliminaryinvestigationintosurgicalprocessmodellingforevaluatingsurgicalproficiency AT wietsegeens revisitingsylvianfissuredissectionapreliminaryinvestigationintosurgicalprocessmodellingforevaluatingsurgicalproficiency AT frederickvangestel revisitingsylvianfissuredissectionapreliminaryinvestigationintosurgicalprocessmodellingforevaluatingsurgicalproficiency AT michaelbruneau revisitingsylvianfissuredissectionapreliminaryinvestigationintosurgicalprocessmodellingforevaluatingsurgicalproficiency |