The BlueDRAGON - A System for Measuring the Kinematics and the Dynamics of Minimally Invasive Surgical Tools In-Vivo

Minimally invasive surgery (MIS) involves a multidimensional series of tasks requiring a synthesis between visual information and the kinematics and dynamics of the surgical tools. Analysis of these sources of information is a key step in mastering MIS but may also be used to define objective criteria for characterizing surgical performance. The BlueDRAGON is a new system for acquiring the kinematics and the dynamics of two endoscopic tools along synchronized with the visual view of the surgical scene. It includes two four-bar passive mechanisms equipped with position and force torque sensors for measuring the positions and the orientations (P/O) of two endoscopic tools along with the forces and torques (F/T) applied by the surgeon's hands. The methodology of decomposing the surgical task is based on a fully connected, 28 finite-states Markov model where each states corresponded to a fundamental tool/tissue interaction based on the tool kinematics and associated with unique F/T signatures. The experimental protocol included seven MIS tasks performed on an animal model (pig) by 30 surgeons at different levels of their residency training including expert surgeons. Preliminary analysis of these data showed that major differences between residents at different skill levels were: (i) the types of tool/tissue interactions being used, (ii) the transitions between tool/tissue interactions being applied by each hand, (iii) time spent while performing each tool/tissue interaction, (iv) the overall completion time, and (v) the variable F/T magnitudes being applied by the subjects through the endoscopic tools. Systems like surgical robots or virtual reality simulators that inherently measure the kinematics and the dynamics of the surgical tool may benefit from inclusion of the proposed methodology for analysis of efficacy and objective evaluation of surgical skills during training.