ArticleSurgical endoscopy2024
Automated task-level autonomy assessment in robotic surgery.
Article in Surgical endoscopy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Ruling the robot: a phase-based analysis of resident autonomy across core robotic general surgery procedures.Surgical endoscopy · 2026Article
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionSurgical autonomy for trainees has remained elusive to quantify. Proportion of active control time (ACT) of a trainee during a robotic case can be used as a broad measure of autonomy. However, this metric lacks in the granular detail of quantifying at what specific steps trainees were actively participating. We aim to quantify trainee involvement during robotic-assisted hiatal hernia repair at a task-specific level.
methodsWe performed a retrospective review of surgical performance data from robotic-assisted hiatal hernia repairs performed. These cases were segmented into 5 tasks by AI-assisted annotation with human review. The segmented tasks included: hiatal dissection, gastric fundus mobilization, mediastinal dissection, cruroplasty and fundoplication. Tasks were excluded if video segmentation of tasks was incorrect. During each task, ACT was recorded for resident, fellow and attending. Resident and fellow ACT per task was compared using the Mann-Whitney U test.
resultsResidents had the highest %ACT in the hiatal dissection (53%), gastric fundus mobilization (84%) and fundoplication (57%) tasks. Fellows had greater than 80% ACT in all 5 tasks, with the highest %ACT in the gastric fundus mobilization (100%) and hiatal dissection (88%). There was a significant difference between resident and fellow ACT during mediastinal dissection and cruroplasty.
conclusionsThis study demonstrates how objective performance metrics and automated case segmentation can quantify trainee participation at a task-specific level. By utilizing data afforded by a robotic surgery platform, we are able to provide an objective and automated form of assessment with minimal impact on the workflow of attendings and residents. Our findings can serve to inform residents on what steps they can expect to be involved in during the procedure, appropriate to their PGY level. With this task-level data, we can provide a roadmap for trainee progression to achieve full surgical autonomy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.