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Sources of Funding: None

Introduction

Global Evaluative Assessment of Robotic Skills (GEARS) is a validated but subjective and time consuming tool. With a novel recording solution (&[Prime]dVLogger&[Prime]), we correlated objective surgeon performance metrics to GEARS during steps of robotic radical prostatectomy (RRP), attempting to automate performance evaluation._x000D_

Methods

We collected surgeon movement data and recorded synchronized video from surgeons performing two distinct RRP steps: seminal vesicles dissection (SVD) and anterior vesicourethral anastomosis (AA), using the dVLogger provided by Intuitive Surgical&[prime]s research team. Two expert robotic surgeons blindly evaluated the video using GEARS. Performance metrics recorded by the dVLogger were correlated to GEARS scores using Spearman&[prime]s correlation test._x000D_

Results

We evaluated 40 cases of RRP. Sixteen surgeons (median 175 (range 30-2000) console cases experience) participated. Total moving time of all robotic instruments and distance traveled by all robotic instruments inversely correlated with most GEARS scores for both SVD and AA steps (r=-0.3 to -0.6, p<0.05) (Table). Dominant and non-dominant hand instrument velocity strongly correlated to GEARS scores during AA (r=0.5 to 0.7, p<0.001) while only the dominant hand instrument velocity correlated with GEARS scores during SVD (r=0.4 to 0.5, p<0.03). Distance traveled by the camera inversely correlated with most GEARS scores only during SVD (r=-0.4 to -0.5, p<0.007). Inversely, frequency of camera position adjustment correlated with most GEARS scores only during AA (r=0.3 to 0.4, p<0.05). Frequency of energy pedal use was correlated with some GEARS scores during SVD (r=0.4, p<0.03).

Conclusions

We found significant correlation between key automated metrics and subjective GEARS scores during a dissection and suturing step of RRP. While strong correlation between automated and GEARS scores may suggest agreement in evaluation of a surgeon&[prime]s performance, disagreement or lack of statistical correlation does not infer that automated assessment or GEARS is superior. Further refinement of this analysis with more tailored performance metrics as well as correlation to clinical outcomes may better delineate the relative value of automated assessment to GEARS._x000D_

Funding

None