CN119180570B - Skill assessment method and system for laparoscopic surgeons - Google Patents
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Abstract
The invention relates to a medical education or demonstration method and a tool, and particularly discloses a laparoscopic operator skill evaluation method and a laparoscopic operator skill evaluation system, wherein the method comprises the steps of S1 constructing an operation skill evaluation index, S2 constructing a reference video library, S3 determining a principal surgery stage and a principal surgery stage to be lifted, S4 determining a personal principal surgery stage and a personal surgery stage to be lifted, S5 evaluating four-quadrant classification of video clips, S6 and personalized evaluation.
Description
Technical Field
The invention relates to a medical education or demonstration method and a tool, and particularly discloses a skill assessment method and a skill assessment system for laparoscopic surgeons.
Background
The laparoscope is an endoscope for intraperitoneal examination and treatment, and is essentially a fiber light source endoscope, comprising a laparoscope, an energy system, a light source system, a perfusion system and an imaging system, wherein the novel laparoscopic surgery is a surgery completed by modern high-tech medical technology by using advanced equipment principles such as electronics, optics and the like, is a trans-time progress of the traditional laparotomy surgery, and is performed in a closed abdominal cavity, wherein an imaging system is connected to a laparoscope body in the abdominal cavity under good cold light source illumination to take an organ in the abdominal cavity on a monitoring screen, and an operating doctor operates an operating instrument outside the abdominal cavity under the monitoring and guiding of a high-tech display screen to perform operations such as exploration, electrocoagulation, hemostasis, tissue separation, incision, suture and the like on pathological tissues. The device is a model of high-tech technologies such as electronics, optics, camera shooting and the like applied in clinical operations, has the characteristics of small trauma, less complications, safety and quick recovery, and can be used for simultaneous examination and treatment due to quick development of surgical endoscopic operations.
The laparoscopic surgery has higher requirements on the operation skills of operators, and how to check, evaluate and improve the laparoscopic surgery skill level of the operators is an important subject in the field of medical clinical education.
Related art is disclosed in the prior art:
The Chinese patent application with the publication number of CN115359260A discloses an image feature extraction and analysis method and system for laparoscopic support skill assessment, and specifically discloses a method which comprises the steps of S100, analyzing and determining describable features and hidden features for assessment according to task characteristics of laparoscopic surgery, obtaining an assessment feature dataset, marking the dataset, S200, extracting the features of an instrument based on a YOLO_v5 algorithm, obtaining the type features of the instrument, obtaining the position and observation distance features of the tail end of the instrument according to BoundingBox, S300, obtaining a partial enlarged image of the tail end of the instrument, manufacturing a non-type tip dataset, training a non-type tip recognition network based on YOLO_v5, sending the non-type tip dataset into another YOLOv network for training, obtaining a tip recognition dataset after training is finished, and S400, quantitatively analyzing the type features of the instrument, the position and the observation distance features of the tail end of the instrument, and the tip recognition dataset.
Chinese patent publication No. CN103299355B discloses a system and method for assessment or improvement of minimally invasive surgical skills, specifically discloses a system and method for minimally invasive surgical skill comprising a minimally invasive surgical system, a video system arranged to record at least one of user interactions with or tasks performed with the minimally invasive surgical system, and a data storage and processing system in communication with the minimally invasive surgical system and in communication with the video system. The minimally invasive surgical system provides at least one of motion data, ergonomic adjustment data, electrical interface interaction data, or mechanical interface interaction data of at least a component of the minimally invasive surgical system in combination with a time registered video signal from the video system. The data storage and processing system processes at least one of the motion data, the ergonomic tuning data, the electrical interface interaction data, or the mechanical interface interaction data to provide performance metrics in conjunction with the time registered video signal to make them available for expert evaluation.
The Chinese patent with the authorized bulletin number of CN111091746B discloses an abdominal cavity open surgery simulation training evaluation system, which specifically discloses a simulation training evaluation system which comprises an abdominal cavity simulation training device (10) for simulating the thoracic cavity and the abdominal cavity of a human body and soft tissues and organs in the abdominal cavity, a surgical knife (20) capable of recording the track of a surgical process, a wireless transmission device and an upper computer (60), wherein the surgical knife is provided for the use of the abdominal cavity open surgery simulation training, and is in communication connection with a wireless transmission module of the surgical knife (20) and used for receiving track data transmitted by the surgical knife so as to evaluate the abdominal cavity open surgery simulation training of the learner by combining with a preset scoring rule.
However, the prior art typified by the above-mentioned patent document still has the following problems:
(1) The existing skill assessment method and system have relatively lack of flexibility in a single sample library, and cannot assess comprehensive skills of different operators, and the assessment method usually only surveys similarity of samples operated by the operators, and relatively has relatively dead plates, and lacks self-adaptive characteristics for operation differences of the different operators.
(2) The conventional skill assessment method and system generally adopts a model training algorithm for a multi-sample library, has higher requirements on abundance of early-stage samples, needs a large number of similar samples, also needs to train by using an artificial intelligent model, a convolution model, an evolution model and the like, and has higher requirements on hardware computing power.
Disclosure of Invention
In order to achieve the purpose of the invention, the invention is realized by the following technical scheme:
a method of skill assessment of a laparoscopic operator, comprising the steps of:
S1, constructing an operation skill evaluation index;
s2, constructing a reference video library, namely selecting reference videos from video data of previous operation of the same type, and constructing the reference video library by tissue expert review;
S3, determining a hospital dominant operation stage and a hospital to-be-lifted operation stage, calculating a difference value of reference time consumption and video time consumption average values, and determining the hospital dominant operation stage and the hospital to-be-lifted operation stage;
S4, determining a personal dominant surgery stage and a personal surgery stage to be lifted, calculating difference values of reference time consumption and time consumption of each surgery stage of an operator, and determining the personal dominant surgery stage and the personal surgery stage to be lifted;
S5, four-quadrant classification of the video clips is evaluated by the operator, and the four-quadrant classification is performed on the video clips evaluated by the operator according to the hospital dominant surgery stage, the hospital surgery stage to be lifted, the personal dominant surgery stage and the personal surgery stage to be lifted;
And S6, personalized evaluation, namely, tissue evaluation expert, wherein the skill of the operator as an evaluation object is evaluated in a scoring way according to the evaluation index based on the four-quadrant classified operator evaluation video clip.
Further, the step S2 specifically includes:
S21, determining an operation mode serving as an examination item according to the type of laparoscopic operation, and dividing the operation mode into a plurality of operation stages Wherein the index i indicates the serial number of the surgical stage,Indicating the i-th stage of the surgery,Indicating the reference time consumption of the surgical phases, I indicating the total number of surgical phases;
S22, segmenting the reference video of the past operation according to the operation stages to obtain a reference video fragment library of a plurality of operation stages Wherein, the method comprises the steps of,Represents the jth reference video clip for the ith surgical stage, J represents the total number of reference video clips,AndRespectively representing the starting time and the ending time of the reference video segment;
S23, for the reference video clip library Counting time to obtain a reference time-consuming libraryWherein, the method comprises the steps of, wherein,Representing a time-consuming data function for the ith surgical stage,、AndThe respective representation is based onAndThe i-th operation stage obtained through statistics is a reference time-consuming mean value, a reference time-consuming lower deviation and a reference time-consuming upper deviation, which satisfy the following conditions:
;
;
;
wherein min and max represent minimum and maximum values, respectively.
Further, the step S3 specifically includes:
s31, reference time consumption based on ith operation stage And reference time-consuming meanConstructing a reference time-consuming bias evaluation setThe method comprises the following steps:
;
;
s32, will The operation phase with positive value is determined as the dominant operation phase of the hospitalThe negative surgical stage is determined as the surgical stage to be lifted in the hospital.
Further, the step S4 specifically includes:
S41, calling an operation video of an operator as an evaluation object, selecting cases without complications and misoperation as evaluation videos, and dividing the evaluation videos into a plurality of evaluation fragments according to an operation stage Wherein, the method comprises the steps of,Represents the evaluation segment of the kth operator for the ith surgical stage, K represents the total number of operators as evaluation targets,AndRespectively representing the starting time and the ending time of the reference video segment;
s42, calculating actual time consumption of the operation stage of the operator as the evaluation object Wherein, the subscript indicates the serial number of the operator as the evaluation object, and the following conditions are satisfied:
;
s43, calculating a personal time consumption difference value between actual time consumption and reference time consumption of an arithmetic operator The method comprises the following steps:
S44, judging the time consumption difference value of the individual Positive and negative of (3);
s45, will A positive value surgical stage is determined to be the personal dominant surgical stage, andA negative surgical phase is determined as the individual's surgical phase to be lifted.
Further, the step S5 specifically includes:
s51, judging whether the personal dominant surgery stage is coincident with the hospital dominant surgery stage;
S52, constructing a four-quadrant evaluation set, classifying evaluation video clips of an operator according to four quadrants, wherein the evaluation video clips are respectively as follows:
The first quadrant is an evaluation video clip belonging to the personal dominant surgery stage and belonging to the hospital dominant surgery stage;
the second quadrant is an evaluation video clip belonging to the personal dominant surgery stage and belonging to the surgery stage to be lifted in the hospital;
the third quadrant is an evaluation video clip belonging to the individual operation stage to be lifted and belonging to the operation stage to be lifted in the hospital;
and the fourth quadrant is an evaluation video clip belonging to the individual operation stage to be lifted and belonging to the dominant operation stage of the hospital.
Further, the evaluation indexes comprise stability of operation of the instrument, positioning accuracy of the instrument, success rate of tissue excision and operation rate of the operator in the operation process.
Further, the step S6 specifically includes that the scoring evaluation includes constructing a polynomial weighted scoring function, wherein the polynomial weighted scoring function specifically includes:
;
;
Wherein X represents the composite score of the skill of the operator, AndRespectively representing a weighting coefficient and expert scoring for the operative stage of the operator in the first quadrant; And Respectively representing a weighting coefficient and expert scoring for the operative stage of the operator in the second quadrant; And Respectively representing a weighting coefficient and expert scoring for the operative stage of the operator in the third quadrant; And Respectively representing a weighting factor and expert scoring for the operative stage of the operator in the fourth quadrant.
Further, if the person takes time differenceNegative and absolute value less than the reference time-consuming deviation, the operative duration of the operative phase of the operator is deemed acceptable.
The invention further provides a skill assessment system of the laparoscopic operator, which is used for implementing the skill assessment method of the laparoscopic operator, and comprises hysteroscopic operation equipment, a video storage unit, a video segmentation unit, a timing unit, a four-quadrant classification unit and an evaluation scoring unit, wherein the video storage unit is used for storing a reference video and an evaluation video, and the video segmentation unit is used for dividing the reference video and the evaluation video into different operation stages.
The beneficial effects of the invention are as follows:
(1) Compared with the traditional method for evaluating the completed video, the method for evaluating the video in the operation stage provided by the invention can perform targeted evaluation on the dominant part and the part to be lifted of different operators, and improves the accuracy of the evaluation.
(2) Compared with the traditional assessment method based on the teaching standard, the assessment method for the hospital teaching level is provided, namely, the assessment is carried out on operators based on the hospital advantage part and the part to be lifted, and the assessment accuracy is improved.
(3) The method provided by the invention aims at preprocessing hysteroscope videos, adopts time as a first assessment parameter, firstly distinguishes time consumption, and then adopts an expert review mode to assess specific operation skills of different operation stages, so that the assessment efficiency is improved, and the efficiency consciousness of operators is enhanced.
(4) According to the method, firstly, the time parameters which are convenient for machine processing are subjected to data classification, so that the subsequent expert review is facilitated, the overall evaluation efficiency and accuracy are improved, the dominant operation stage of an operator can be rapidly found, and the subsequent popularization and study are facilitated.
(5) The invention provides a four-quadrant evaluation video classification method, which can quickly understand the difference between the surgical skill of an operator and the superiority stage of a hospital, particularly can quickly find out the superiority of the hospital but the operator needs to be lifted and the portion of the hospital which needs to be lifted but the advantage of the operator, and can pertinently help the operator or the hospital to learn and improve later.
(6) The present invention provides a weighted comprehensive score algorithm, particularly to assign a higher weighting factor to the portion of the home to be upgraded but the advantage of the operator, to highlight the value of the individual skills of the operator.
Drawings
FIG. 1 is a schematic flow chart of the method of the present invention;
FIG. 2 is a four-quadrant classification diagram of the present invention.
Detailed Description
The present invention will be further described in detail with reference to the following examples, which are only for the purpose of illustrating the invention and are not to be construed as limiting the scope of the invention.
Example 1
According to the method shown in fig. 1, a method for skill assessment of a laparoscopic surgeon comprises the steps of:
S1, constructing an operation skill evaluation index;
s2, constructing a reference video library, namely selecting reference videos from video data of previous operation of the same type, and constructing the reference video library by tissue expert review;
S3, determining a hospital dominant operation stage and a hospital to-be-lifted operation stage, calculating a difference value of reference time consumption and video time consumption average values, and determining the hospital dominant operation stage and the hospital to-be-lifted operation stage;
S4, determining a personal dominant surgery stage and a personal surgery stage to be lifted, calculating difference values of reference time consumption and time consumption of each surgery stage of an operator, and determining the personal dominant surgery stage and the personal surgery stage to be lifted;
S5, four-quadrant classification of the video clips is evaluated by the operator, and the four-quadrant classification is performed on the video clips evaluated by the operator according to the hospital dominant surgery stage, the hospital surgery stage to be lifted, the personal dominant surgery stage and the personal surgery stage to be lifted;
And S6, personalized evaluation, namely, tissue evaluation expert, wherein the skill of the operator as an evaluation object is evaluated in a scoring way according to the evaluation index based on the four-quadrant classified operator evaluation video clip.
The step S2 specifically comprises the following steps:
S21, determining an operation mode serving as an examination item according to the type of laparoscopic operation, and dividing the operation mode into a plurality of operation stages Wherein the index i indicates the serial number of the surgical stage,Indicating the i-th stage of the surgery,Indicating the reference time consumption of the surgical phases, I indicating the total number of surgical phases;
s22, segmenting the reference video of the past operation according to the operation stages to obtain a reference video segment library of a plurality of operation stages Wherein, the method comprises the steps of,Represents the jth reference video clip for the ith surgical stage, J represents the total number of reference video clips,AndRespectively representing the starting time and the ending time of the reference video segment;
S23, for a reference video clip library Counting time to obtain a reference time-consuming libraryWherein, the method comprises the steps of, wherein,Representing a time-consuming data function for the ith surgical stage,、AndThe respective representation is based onAndThe i-th operation stage obtained through statistics is a reference time-consuming mean value, a reference time-consuming lower deviation and a reference time-consuming upper deviation, which satisfy the following conditions:
;
;
;
wherein min and max represent minimum and maximum values, respectively.
The step S3 specifically comprises the following steps:
s31, reference time consumption based on ith operation stage And reference time-consuming meanConstructing a reference time-consuming bias evaluation setThe method comprises the following steps:
;
;
s32, will The operation phase with positive value is determined as the dominant operation phase of the hospitalThe negative surgical stage is determined as the surgical stage to be lifted in the hospital.
The step S4 specifically comprises the following steps:
S41, calling an operation video of an operator as an evaluation object, selecting cases without complications and misoperation as evaluation videos, and dividing the evaluation videos into a plurality of evaluation fragments according to an operation stage Wherein, the method comprises the steps of,Represents the evaluation segment of the kth operator for the ith surgical stage, K represents the total number of operators as evaluation targets,AndRespectively representing the starting time and the ending time of the reference video segment;
s42, calculating actual time consumption of the operation stage of the operator as the evaluation object Wherein, the subscript indicates the serial number of the operator as the evaluation object, and the following conditions are satisfied:
;
s43, calculating a personal time consumption difference value between actual time consumption and reference time consumption of an arithmetic operator The method comprises the following steps:
;
S44, judging the time consumption difference value of the individual Positive and negative of (3);
s45, will A positive value surgical stage is determined to be the personal dominant surgical stage, andA negative surgical phase is determined as the individual's surgical phase to be lifted.
The step S5 specifically comprises the following steps:
s51, judging whether the personal dominant surgery stage is coincident with the hospital dominant surgery stage;
s52, constructing a four-quadrant evaluation set, classifying evaluation video segments of an operator according to four quadrants, wherein the four quadrants are respectively a first quadrant which belongs to a personal dominant surgery stage and belongs to a home dominant surgery stage, a second quadrant which belongs to a personal dominant surgery stage and belongs to a home to-be-lifted surgery stage, a third quadrant which belongs to a personal to-be-lifted surgery stage and belongs to a home to-be-lifted surgery stage, and a fourth quadrant which belongs to a personal to-be-lifted surgery stage and belongs to a home dominant surgery stage.
The evaluation indexes comprise stability of operation of the instrument, positioning accuracy of the instrument, success rate of tissue excision and operation rate of the operator in the operation process.
The step S6 specifically comprises the steps of evaluating the scoring includes constructing a polynomial weighted scoring function, wherein the polynomial weighted scoring function specifically comprises the following steps:
;
;
Wherein X represents the composite score of the skill of the operator, AndRespectively representing a weighting coefficient and expert scoring for the operative stage of the operator in the first quadrant; And Respectively representing a weighting coefficient and expert scoring for the operative stage of the operator in the second quadrant; And Respectively representing a weighting coefficient and expert scoring for the operative stage of the operator in the third quadrant; And Respectively representing a weighting factor and expert scoring for the operative stage of the operator in the fourth quadrant.
If the time consumption of the person is differentNegative and absolute value less than the reference time-consuming deviation, the operative duration of the operative phase of the operator is deemed acceptable.
Example two
A skill evaluation system of a laparoscopic operator is used for implementing a skill evaluation method of the laparoscopic operator, and comprises hysteroscopic operation equipment, a video storage unit, a video segmentation unit, a timing unit, a four-quadrant classification unit and an evaluation scoring unit, wherein the video storage unit is used for storing a reference video and an evaluation video, and the video segmentation unit is used for dividing the reference video and the evaluation video into different operation stages.
The foregoing has shown and described the basic principles, principal features and advantages of the invention. It will be understood by those skilled in the art that the present invention is not limited to the embodiments described above, and that the above embodiments and descriptions are merely illustrative of the principles of the present invention, and various changes and modifications may be made without departing from the spirit and scope of the invention, which is defined in the appended claims. The scope of the invention is defined by the appended claims and equivalents thereof.
Claims (6)
1. A method of skill assessment for a laparoscopic surgeon, comprising the steps of:
S1, constructing an operation skill evaluation index;
s2, constructing a reference video library, namely selecting reference videos from video data of previous operation of the same type, and constructing the reference video library by tissue expert review;
S3, determining a hospital dominant operation stage and a hospital to-be-lifted operation stage, calculating a difference value of reference time consumption and video time consumption average values, and determining the hospital dominant operation stage and the hospital to-be-lifted operation stage, wherein the method specifically comprises the following steps:
s31, reference time consumption based on ith operation stage And reference time-consuming meanConstructing a reference time-consuming bias evaluation setThe method comprises the following steps:;;
wherein, Representing reference time-consuming bias estimate sets, respectivelyIs a combination of the elements of (1),Is the total number of elements;
s32, will The operation phase with positive value is determined as the dominant operation phase of the hospitalThe negative operation stage is determined as the operation stage to be lifted in the hospital;
s4, determining a personal dominant surgery stage and a personal surgery stage to be lifted, calculating difference values of reference time consumption and time consumption of each surgery stage of an operator, and determining the personal dominant surgery stage and the personal surgery stage to be lifted, wherein the method specifically comprises the following steps:
S41, calling an operation video of an operator as an evaluation object, and selecting cases without complications and misoperation as evaluation videos;
slicing an evaluation video into multiple evaluation segments according to the stage of surgery Wherein, the method comprises the steps of,Represents the evaluation segment of the kth operator for the ith surgical stage, K represents the total number of operators as evaluation targets,AndRespectively representing the starting time and the ending time of the evaluation video segment;
s42, calculating actual time consumption of the operation stage of the operator as the evaluation object Wherein, the subscript indicates the serial number of the operator as the evaluation object, and the following conditions are satisfied:;
s43, calculating a personal time consumption difference value between actual time consumption and reference time consumption of an arithmetic operator The method comprises the following steps:;
S44, judging the time consumption difference value of the individual Positive and negative of (3);
s45, will A positive value surgical stage is determined to be the personal dominant surgical stage, andA negative surgical stage is determined as a surgical stage to be lifted by the individual;
S5, four-quadrant classification of the evaluation video clips of the operator is carried out according to the dominant surgery stage of the hospital, the surgery stage to be lifted of the hospital, the personal dominant surgery stage and the personal surgery stage to be lifted, and the four-quadrant classification of the evaluation video clips of the operator is carried out specifically comprises the following steps:
s51, judging whether the personal dominant surgery stage is coincident with the hospital dominant surgery stage;
S52, constructing a four-quadrant evaluation set, classifying evaluation video clips of an operator according to four quadrants, wherein the evaluation video clips are respectively as follows:
The first quadrant is an evaluation video clip belonging to the personal dominant surgery stage and belonging to the hospital dominant surgery stage;
the second quadrant is an evaluation video clip belonging to the personal dominant surgery stage and belonging to the surgery stage to be lifted in the hospital;
the third quadrant is an evaluation video clip belonging to the individual operation stage to be lifted and belonging to the operation stage to be lifted in the hospital;
the fourth quadrant is an evaluation video clip belonging to the individual operation stage to be lifted and belonging to the hospital dominant operation stage;
And S6, personalized evaluation, namely, tissue evaluation expert, wherein the skill of the operator as an evaluation object is evaluated in a scoring way according to the evaluation index based on the four-quadrant classified operator evaluation video clip.
2. The method for evaluating the skill of a laparoscopic surgeon according to claim 1, wherein the step S2 comprises the following steps:
S21, determining an operation mode serving as an examination item according to the type of laparoscopic operation, and dividing the operation mode into a plurality of operation stages Wherein the index i indicates the serial number of the surgical stage,Indicating the i-th stage of the surgery,Indicating the reference time consumption of the surgical phases, I indicating the total number of surgical phases;
S22, segmenting the reference video of the past operation according to the operation stages to obtain a reference video fragment library of a plurality of operation stages Wherein, the method comprises the steps of,Represents the jth reference video clip for the ith surgical stage, J represents the total number of reference video clips,AndRespectively representing the starting time and the ending time of the reference video segment;
S23, for the reference video clip library Counting time to obtain a reference time-consuming libraryWherein, the method comprises the steps of, wherein,Representing a time-consuming data function for the ith surgical stage,、AndThe respective representation is based onAndThe i-th operation stage obtained through statistics is a reference time-consuming mean value, a reference time-consuming lower deviation and a reference time-consuming upper deviation, which satisfy the following conditions:;
;
;
wherein min and max represent minimum and maximum values, respectively.
3. The method of claim 2, wherein the evaluation criteria include stability of the operation of the instrument during the operation, accuracy of positioning the instrument, success rate of tissue removal, and rate of operation.
4. The method for skill assessment of a laparoscopic surgeon according to claim 3, wherein step S6 comprises constructing a polynomial weighted scoring function, wherein said polynomial weighted scoring function is:
;
;
Wherein X represents the composite score of the skill of the operator, AndRespectively representing a weighting coefficient and expert scoring for the operative stage of the operator in the first quadrant; And Respectively representing a weighting coefficient and expert scoring for the operative stage of the operator in the second quadrant; And Respectively representing a weighting coefficient and expert scoring for the operative stage of the operator in the third quadrant; And Respectively representing a weighting factor and expert scoring for the operative stage of the operator in the fourth quadrant.
5. The method of claim 4, wherein step S6 further comprises the step of if the person takes time a different valueNegative and absolute value less than the reference time-consuming deviation, the operative duration of the operative phase is considered acceptable for the operator.
6. A laparoscopic operator skill assessment system for implementing the laparoscopic operator skill assessment method according to any one of claims 1-5, characterized in that the skill assessment system comprises a hysteroscopic surgical device, a video storage unit for storing a reference video and an evaluation video, a video segmentation unit for dividing the reference video and the evaluation video into different surgical phases, a timing unit, a four-quadrant classification unit, and an evaluation scoring unit.
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