Neurosurgical performance between experts and trainees: Evidence from drilling task

Abstract

Background: Lumbar laminectomy is a common neurosurgery that requires precise manipulation of power drills. We examined the fine movement controls of novice neurosurgeons in drilling tasks and compared its accuracy to expert surgeons' performance.

Methods: Four experts and three novice neurosurgeons performed a lumbar laminectomy on a three-dimensional printed spine model. Scene video and surgeons' eye movements were recorded. Independent sample t-Tests were conducted on the number of jump, total fixation durations, pre-jump fixation durations, post-jump fixation durations and jump distances over novice and expert surgeons.

Results: No statistically significant differences were recorded in terms of total fixations and pre-jump fixation durations. However, novices had more jumping events, greater jump distances and longer post-jump fixation durations when compared to expert neurosurgeons.

Conclusion: Differences in movement accuracy and eye measures were found between expert and novice neurosurgeons during a simulated microscopic lumbar laminectomy. A more comprehensive understanding of surgeon's fine movement control mechanism and eye-hand coordination in microsurgery is essential for us before building an enhanced training protocol for surgical residents in neurosurgery.

Keywords: competency assessment; drill; eye tracking; microsurgery; surgical training.