EVA: Endoscopic Video Analysis of the surgical scene for the assessment of MIS psychomotor skills

The present work covers the first validation efforts of the EVA Tracking System for the assessment of minimally invasive surgery (MIS) psychomotor skills. Instrument movements were recorded for 42 surgeons (4 expert, 22 residents, 16 novice medical students) and analyzed for a box trainer peg transfer task. Construct validation was established for 7/9 motion analysis parameters (MAPs). Concurrent validation was determined for 8/9 MAPs against the TrEndo Tracking System. Finally, automatic determination of surgical proficiency based on the MAPs was sought by 3 different approaches to supervised classification (LDA, SVM, ANFIS), with accuracy results of 61.9%, 83.3% and 80.9% respectively. Results not only reflect on the validation of EVA for skills? assessment, but also on the relevance of motion analysis of instruments in the determination of surgical competence.