Eyes and movement differences in unconscious state during microscopic procedures.

Microsurgery is one of the techniques that is increasingly being adopted in many surgical fields. However, the acquisition and transfer of microsurgical skills primarily depend on experience. Additionally, opportunities to improve microsurgical skills are limited and a uniform evaluation system is lacking. Therefore, the aim of this study was to understand the physical characteristics of experienced and novice surgeons and to propose efficient training and evaluation methods from an educational perspective. In this study, nine hand surgeons and six orthopedic surgeons were included in expert group E and novice group N, respectively. An eye tracker and surface electromyography were used. They were asked to perform the suturing procedure under the same conditions. The viewpoint distribution area was larger in group N than in group E (p < 0.01). In group E, the pupil diameter increased only in a limited phase. The standard deviation of the distance between gaze and hand movements was smaller in group E, especially for gaze. Group E used the synergy of the same muscles to create movement. This study showed that there are differences in eye movements and unconscious body control during suturing techniques under the microscope between experienced users and novices.