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Action-related eye measures to assess surgical expertise.

ABSTRACT: Eye-tracking offers a new list of performance measures for surgeons. Previous studies of eye-tracking have reported that action-related fixation is a good measuring tool for elite task performers. Other measures, including early eye engagement to target and early eye disengagement from the previous subtask, were also reported to distinguish between different expertise levels. These parameters were examined during laparoscopic surgery simulations in the present study, with a goal to identify the most useful measures for distinguishing surgical expertise. Surgical operators, including experienced surgeons (expert), residents (intermediate), and university students (novice), were required to perform a laparoscopic task involving reaching, grasping, and loading, while their eye movements and performance videos were recorded. Spatiotemporal features of eye-hand coordination and action-related fixation were calculated and compared among the groups. The study included five experienced surgeons, seven residents, and 14 novices. Overall, experts performed tasks faster than novices. Examining eye-hand coordination on each subtask, it was found that experts managed to disengage their eyes earlier from the previous subtask, whereas novices disengaged their eyes from previous subtask with a significant delay. Early eye engagement to the current subtask was observed for all operators. There was no difference in action-related fixation between experienced surgeons and novices. Disengage time was strongly associated with the surgical experience score of the operators, better than both early-engage time and action-related fixation. The spatiotemporal features of surgeons' eye-hand coordination can be used to assess level of surgical experience.

SUBMITTER: Zheng B

PROVIDER: S-EPMC8413367 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:The aim of this study was to search for oculomotor correlates of expertise in visual arts, in particular with regard to paintings. Achieving this goal was possible by gathering data on eye movements of two groups of participants: experts and non-experts in visual arts who viewed and appreciated the aesthetics of paintings. In particular, we were interested in whether visual arts experts more accurately recognize a balanced composition in one of the two paintings being compared simultaneously, and whether people who correctly recognize harmonious paintings are characterized by a different visual scanning strategy than those who do not recognize them. For the purposes of this study, 25 paintings with an almost ideal balanced composition have been chosen. Some of these paintings are masterpieces of the world cultural heritage, and some of them are unknown. Using Photoshop, the artist developed three additional versions of each of these paintings, differing from the original in the degree of destruction of its harmonious composition: slight, moderate, or significant. The task of the participants was to look at all versions of the same painting in pairs (including the original) and decide which of them looked more pleasing. The study involved 23 experts in art, students of art history, art education or the Academy of Fine Arts, and 19 non-experts, students in the social sciences and the humanities. The experimental manipulation of comparing pairs of paintings, whose composition is at different levels of harmony, has proved to be an effective tool for differentiating people because of their ability to distinguish paintings with balanced composition from an unbalanced one. It turned out that this ability only partly coincides with expertise understood as the effect of education in the field of visual arts. We also found that the eye movements of people who more accurately appreciated paintings with balanced composition differ from those who more liked their altered versions due to dwell time, first and average fixation duration and number of fixations. The familiarity of paintings turned out to be the factor significantly affects both the aesthetic evaluation of paintings and eye movement.

Project description:BackgroundRetroperitoneal sarcoma (RPS) is a rare disease often requiring multi-visceral and wide margin resections for which a resection in a sarcoma center is advised. Midline incision seems to be the access of choice. However, up to now there is no evidence for the best surgical access. This study aimed to analyze the oncological outcome according to the surgical expertise and also the incision used for the resection.MethodsAll patients treated for RPS between 2007 and 2018 at the Department of Visceral Surgery and Medicine of the University Hospital Bern and receiving a RPS resection in curative intent were included. Patient- and treatment specific factors as well as local recurrence-free, disease-free and overall survival were analyzed in correlation to the hospital type where the resection occurred.ResultsThirty-five patients were treated for RPS at our center. The majority received their primary RPS resection at a sarcoma center (SC = 23) the rest of the resection were performed in a non-sarcoma center (non-SC = 12). Median tumor size was 24 cm. Resections were performed via a midline laparotomy (ML = 31) or flank incision (FI = 4). All patients with a primary FI (n = 4) were operated in a non-SC (p = 0.003). No patient operated at a non-SC received a multivisceral resection (p = 0.004). Incomplete resection (R2) was observed more often when resection was done in a non-SC (p = 0.013). Resection at a non-SC was significantly associated with worse recurrence-free survival and disease-free survival after R0/1 resection (2 vs 17 months; Log Rank p-value = 0.02 respectively 2 vs 15 months; Log Rank p-value < 0.001).ConclusionsResection at a non-SC is associated with more incomplete resection and worse outcome in RPS surgery. Inadequate access, such as FI, may prevent complete resection and multivisceral resection if indicated and demonstrates the importance of surgical expertise in the outcome of RPS resection.

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Action-related eye measures to assess surgical expertise.

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