Decoding robotic surgery skills

September 11, 2018

LOS ANGELES - Researchers from the Keck School of Medicine of USC are looking to technology to help deconstruct expert surgeons' robotic surgery skills so they can create an objective, standardized way to train the next generation of surgeons. Using a data recorder plugged into a robotic surgery system, the team analyzed expert and novice surgeons' movements during the reconstruction step of robotic radical prostatectomy, a common surgery for prostate cancer. The data helped the team decode surgical skills, develop a needle-driving gesture classification system and create a training tutorial. The results of their study will appear in the October 2018 issue of The Journal of Urology.

"Although robotic surgery is a widely adopted minimally invasive option for treating prostate cancer, standardized training for it doesn't exist yet," says the study's corresponding author, Andrew Hung, MD, assistant professor of clinical urology at the Keck School. "In order to create a methodical, streamlined training tutorial for this main reconstruction step of the prostate surgery, we relied on automated performance metrics and observation to objectively measure surgeon performance."

Using both video and movement data recorded from 70 surgeries, the study found that experts outperformed novices in completion time, instrument movement efficiency and camera manipulation. Experts also had fewer needle-driving attempts and less tissue trauma.

The researchers were also able to identify 14 common needle-driving gestures, which were classified as combinations of forehand, backhand, flush-hand, overhand or underhand. Compared to standardized gestures, random sequences of gestures were associated with lower efficiency, more needle-driving attempts and more tissue trauma.

The data were then used to develop a tutorial that broke the complex surgical step into smaller, discrete steps.

"While there is no single perfect way to do a perfect operation, creating a standardized method for robotic surgery training provides surgeons a common training ground," Hung says.

Hung and his colleagues are currently testing the efficacy of the tutorial with a group of medical students in the research lab at the Keck School. The team is hopeful that their approach to developing this training tutorial could one day be applied to any procedure in any kind of robotic operation.

Robotic radical prostatectomy accounts for 87 percent of prostate cancer surgeries in the United States.
-end-
About the Keck School of Medicine of USC

Founded in 1885, the Keck School of Medicine of USC is among the nation's leaders in innovative patient care, scientific discovery, education and community service. It is part of Keck Medicine of USC, the University of Southern California's medical enterprise, one of only two university-owned academic medical centers in the Los Angeles area. This includes Keck Medical Center of USC, composed of Keck Hospital of USC and USC Norris Cancer Hospital. The two world-class, USC-owned hospitals are staffed by more than 500 physicians who are faculty at the Keck School. The school has more than 1,750 full-time faculty members and voluntary faculty of more than 2,400 physicians. These faculty direct the education of approximately 800 medical students and 1,000 students pursuing graduate and postgraduate degrees. The school trains more than 900 resident physicians in more than 50 specialty or subspecialty programs and is the largest educator of physicians practicing in Southern California. Together, the school's faculty and residents serve more than 1.5 million patients each year at Keck Hospital of USC and USC Norris Cancer Hospital, as well as USC-affiliated hospitals, Children's Hospital Los Angeles and Los Angeles County + USC Medical Center. Keck School faculty also conduct research and teach at several research centers and institutes, including the Eli and Edythe Broad Center for Stem Cell Research and Regenerative Medicine at USC, USC Cardiovascular Thoracic Institute, USC Institute of Urology, USC Mark and Mary Stevens Neuroimaging and Informatics Institute, USC Norris Comprehensive Cancer Center, USC Roski Eye Institute and Zilkha Neurogenetic Institute.

In 2018, U.S. News & World Report ranked the Keck School among the top 35 medical schools in the country.

For more information, go to keck.usc.edu.

University of Southern California - Health Sciences

Related Prostate Cancer Articles from Brightsurf:

Low risk of cancer spread on active surveillance for early prostate cancer
Men undergoing active surveillance for prostate cancer have very low rates - one percent or less - of cancer spread (metastases) or death from prostate cancer, according to a recent study published in the Journal of Urology®, an Official Journal of the American Urological Association (AUA).

ESMO 2020: Breast cancer drug set to transform prostate cancer treatment
A drug used to treat breast and ovarian cancer can extend the lives of some men with prostate cancer and should become a new standard treatment for the disease, concludes a major trial which is set to change clinical practice.

Major trial shows breast cancer drug can hit prostate cancer Achilles heel
A drug already licensed for the treatment of breast and ovarian cancers is more effective than targeted hormone therapy at keeping cancer in check in some men with advanced prostate cancer, a major clinical trial reports.

The Lancet: Prostate cancer study finds molecular imaging could transform management of patients with aggressive cancer
Results from a randomised controlled trial involving 300 prostate cancer patients find that a molecular imaging technique is more accurate than conventional medical imaging and recommends the scans be introduced into routine clinical practice.

Common genetic defect in prostate cancer inspires path to new anti-cancer drugs
Researchers found that, in prostate cancer, a mutation leading to the loss of one allele of a tumor suppressor gene known as PPP2R2A is enough to worsen a tumor caused by other mutations.

First prostate cancer therapy to target genes delays cancer progression
For the first time, prostate cancer has been treated based on the genetic makeup of the cancer, resulting in delayed disease progression, delayed time to pain progression, and potentially extending lives in patients with advanced, metastatic prostate cancer, reports a large phase 3 trial.

Men taking medications for enlarged prostate face delays in prostate cancer diagnosis
University of California San Diego School of Medicine researchers report that men treated with medications for benign prostatic hyperplasia (enlarged prostate) experienced a two-year delay in diagnosis of their prostate cancer and were twice as likely to have advanced disease upon diagnosis.

CNIO researchers confirm links between aggressive prostate cancer and hereditary breast cancer
The study has potential implications for families with members suffering from these types of tumours who are at an increased risk of developing cancer.

Distinguishing fatal prostate cancer from 'manageable' cancer now possible
Scientists at the University of York have found a way of distinguishing between fatal prostate cancer and manageable cancer, which could reduce unnecessary surgeries and radiotherapy.

Researchers find prostate cancer drug byproduct can fuel cancer cells
A genetic anomaly in certain men with prostate cancer may impact their response to common drugs used to treat the disease, according to new research at Cleveland Clinic.

Read More: Prostate Cancer News and Prostate Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.