Method and system for evaluating skill of laparoscopic surgery operator

Abstract

The invention relates to a medical education or demonstration method and appliance, and particularly discloses a skill assessment method and system for a laparoscopic surgery operator. The method comprises the steps of S1, constructing a surgical skill evaluation index, S2, constructing a reference video library, S3, determining a dominant surgical stage and a to-be-promoted surgical stage of the hospital, S4, determining a personal dominant surgical stage and a personal to-be-promoted surgical stage, S5, performing four-quadrant classification on an operator evaluation video clip, and S6, performing personalized evaluation. According to the video evaluation method for the operation stage, the dominant parts and the to-be-improved parts of different operators can be evaluated in a targeted mode, and the evaluation accuracy is improved.

Description

Technical Field

[0001] The invention relates to a medical education or demonstration method and tool, and specifically discloses a skill evaluation method and system for laparoscopic surgeons. Background Art

[0002] Laparoscope is an endoscope used for intra-abdominal examination and treatment. It is essentially a fiber light source endoscope, including laparoscope, energy system, light source system, perfusion system and imaging system. The new laparoscopic surgery is a surgery performed by modern high-tech medical technology using advanced electronic and optical equipment principles. It is a cross-era progress of traditional laparotomy. It is a surgery performed in a closed abdominal cavity: the camera system is illuminated by a good cold light source and connected to the laparoscope body in the abdominal cavity to photograph the organs in the abdominal cavity on the monitoring screen. The surgeon manipulates the surgical instruments outside the abdominal cavity under the monitoring and guidance of the high-tech display screen to explore, electrocoagulate, stop bleeding, separate and cut tissues, and suture the diseased tissues. It is a model of the application of high-tech technologies such as electronics, optics, and photography in clinical surgery. It has the characteristics of less trauma, fewer complications, safety, and fast recovery. Surgical laparoscopic surgery has developed rapidly and can be examined and treated at the same time.

[0003] Laparoscopic surgery has high requirements on the surgeon's operating skills. How to assess, evaluate and improve the surgeon's laparoscopic surgery skills is an important topic in the field of medical clinical education.

[0004] Related technologies are disclosed in the prior art: The Chinese patent application with publication number CN115359260A discloses an image feature extraction and analysis method and system for laparoscopic steering skill assessment; specifically disclosed: the method includes S100: determining descriptive features and hidden features for assessment based on task characteristic analysis of laparoscopic surgery, obtaining an assessment feature data set, and labeling the data set; S200: extracting instrument features based on the YOLO_v5 algorithm, obtaining instrument type features, and obtaining the position and observation distance features of the instrument end based on the BoundingBox; S300: obtaining a local magnified image of the instrument end to produce a category-free tip data set, training a category-free tip recognition network based on YOLO_v5, and sending the category-free tip data set to another YOLOv5 network for training, and obtaining a tip recognition data set after the training is completed; S400: quantitatively analyzing instrument type features, instrument end position and observation distance features, and tip recognition data sets. The method of the present invention provides an objective function for the optimization control of a laparoscopic autonomous steering robot.

[0005] The Chinese patent with the authorization announcement number CN103299355B discloses a system and method for evaluating or improving minimally invasive surgical skills; specifically disclosed: including: a minimally invasive surgical system; a video system, which is arranged to record at least one of the user's interaction with the minimally invasive surgical system or the tasks performed with the minimally invasive surgical system; and a data storage and processing system that communicates with the minimally invasive surgical system and 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, ergonomic adjustment data, electrical interface interaction data, or mechanical interface interaction data to provide a performance metric in combination with the time-registered video signal so that it can be used by an expert for evaluation.

[0006] A Chinese patent with the authorization announcement number CN111091746B discloses a system for evaluating simulation training of open abdominal surgery. Specifically disclosed are: a chest and abdominal simulation training device (10) for simulating the chest and abdominal cavity of a human body, as well as the soft tissues and organs inside the abdominal cavity, for trainees to use in simulation training of open abdominal surgery; a scalpel (20) capable of recording the trajectory of the surgical process, for trainees to use in simulation training of open abdominal surgery, the scalpel being provided with a wireless transmission device; and a host computer (60) communicating with the wireless transmission module of the scalpel (20) to receive the trajectory data transmitted by the scalpel, so as to evaluate the trainees' simulation training of open abdominal surgery in combination with a preset scoring rule.

[0007] However, the prior art represented by the above patent documents still has the following problems: (1) The existing skill assessment methods and systems lack flexibility in their single sample libraries and are unable to assess the comprehensive skills of different operators. The assessment methods usually only examine the similarities of samples performed by operators, which is relatively rigid and lacks the ability to adapt to the differences in operations performed by different operators.

[0008] (2) Existing skill assessment methods and systems’ multi-sample libraries usually adopt model training algorithms, which have high requirements on the abundance of previous samples and require a large number of similar samples. They also need to be trained using artificial intelligence models, convolutional models, evolutionary models, etc., which have high requirements on hardware computing power. Summary of the invention

[0009] To achieve the purpose of the present invention, the present invention is implemented by the following technical solutions: A method for assessing the skills of a laparoscopic surgeon comprises the following steps: S1. Construct surgical skills assessment indicators; S2. Build a reference video library; organize expert review, select reference videos from previous video materials of similar surgeries, and build a reference video library; S3. Determine the hospital's advantageous surgical stage and the hospital's surgical stage to be improved; calculate the difference between the reference time and the average video time to determine the hospital's advantageous surgical stage and the hospital's surgical stage to be improved; S4, determining the individual's advantageous surgical stage and the individual's surgical stage to be improved; calculating the difference between the reference time and the surgeon's time spent in each surgical stage, and determining the individual's advantageous surgical stage and the individual's surgical stage to be improved; S5. Four-quadrant classification of surgeon evaluation video clips; according to the hospital's advantageous surgical stage, the hospital's surgical stage to be improved, the individual's advantageous surgical stage and the individual's surgical stage to be improved, the surgeon evaluation video clips are classified into four quadrants; S6. Personalized assessment: Organize assessment experts to score and evaluate the skills of the surgeons who are the assessment objects based on the surgeon assessment video clips classified into four quadrants and the assessment indicators.

[0010] Furthermore, step S2 specifically includes: S21. Determine the surgical procedure as the assessment item according to the type of laparoscopic surgery, and divide the surgical procedure into multiple surgical stages ; Among them, the subscript i Indicates the sequence number of the surgical stage, Indicates i The surgical stage represents the reference time of the surgical stage, and I represents the total number of surgical stages; S22, dividing the reference video of the previous surgery according to the surgical stage to obtain a reference video clip library of multiple surgical stages ;in, Indicates that for i The first stage of surgery j reference video clips, J represents the total number of reference video clips, and Respectively represent the start time and end time of the reference video segment; S23, the reference video clip library Perform time statistics to obtain a reference time-consuming library ,in, Indicates that for i The time-consuming data function of each surgical stage, , and Respectively based on and The statistically obtained iThe reference time mean, reference time lower deviation and reference time upper deviation of each surgical stage meet the following requirements: ; ; ; Among them, min and max represent the minimum value and the maximum value respectively.

[0011] Furthermore, step S3 specifically includes: S31, based on i Reference time for each surgical stage and the mean reference time , build a reference time deviation evaluation set ,satisfy: ; ; S32, The surgical stage with a positive value is determined as the hospital's dominant surgical stage. The surgical stage with a negative result is determined as the surgical stage to be promoted in this hospital.

[0012] Furthermore, step S4 specifically includes: S41. Retrieve the surgical videos of the surgeons to be evaluated, and select the cases without complications and erroneous operations as evaluation videos; and divide the evaluation videos into multiple evaluation segments according to the surgical stages. ;in, Indicates that for i The first stage of surgery k evaluation segments of operators, K represents the total number of operators to be evaluated, and Respectively represent the start time and end time of the reference video segment; S42. Calculate the actual time taken for the surgical stage by the surgeon being evaluated , where the subscript represents the serial number of the surgeon being evaluated; satisfies: ; S43. Calculate the difference between the actual time consumed by the operator and the reference time consumed ,satisfy:

[0013] S44. Determine individual time difference The positive and negative nature of S45, The surgical stage with a positive value is determined as the individual advantage surgical stage. The negative surgical stage is determined as the individual's surgical stage to be promoted.

[0014] Furthermore, step S5 specifically includes: S51. Determine whether the individual's advantageous surgical stage overlaps with the hospital's advantageous surgical stage; S52, constructing a four-quadrant evaluation set; classifying the operator's evaluation video clips according to the four quadrants, namely: Quadrant 1: Evaluation video clips that belong to the individual's advantage surgical stage and the hospital's advantage surgical stage; The second quadrant: evaluation video clips that belong to the stage of surgery that is the individual's advantage and the stage of surgery that needs to be improved in the hospital; The third quadrant: evaluation video clips that belong to the individual's pending surgery stage and the hospital's pending surgery stage; The fourth quadrant: evaluation video clips that belong to the individual's surgery stage for improvement and the hospital's advantage surgery stage.

[0015] Furthermore, the evaluation indicators include the operator's stability in operating the instrument during the operation, the accuracy of instrument positioning, the success rate of tissue resection, and the operation rate.

[0016] Further, step S6 specifically includes: the scoring evaluation includes constructing a polynomial weighted scoring function, and the polynomial weighted scoring function is specifically: ; ; Among them, X represents the comprehensive score of the operator's skills. and They represent the weighted coefficient and expert score for the operator in the first quadrant of the surgical stage; and They represent the weighted coefficient and expert score for the operator in the second quadrant of the surgical stage; and They represent the weighted coefficient and expert score for the operator's surgical stage in the third quadrant; and They represent the weighted coefficient and expert score for the surgeon in the fourth quadrant of the surgical stage.

[0017] Furthermore, if the individual time difference If it is negative and its absolute value is smaller than the upper deviation of the reference time consumption, the operation time of the surgeon in this stage of the surgery is considered to be qualified.

[0018] The present invention also provides a skill evaluation system for laparoscopic surgeons, which is used to implement the skill evaluation method for laparoscopic surgeons. The skill evaluation system includes hysteroscopic surgical equipment, a video storage unit, a video segmentation unit, a timing unit, a four-quadrant classification unit, and an evaluation scoring unit; the video storage unit is used to store reference videos and evaluation videos; the video segmentation unit is used to divide the reference videos and evaluation videos into different surgical stages.

[0019] The beneficial effects of the present invention are: (1) Compared with the traditional method of evaluating the completed video, the present invention provides a video evaluation method for the surgical stage, which can conduct targeted evaluation on the advantages and areas to be improved of different surgeons, thereby improving the accuracy of the evaluation.

[0020] (2) Compared with the traditional assessment method based on teaching standards, this application provides an assessment method for the teaching level of the hospital, that is, based on the hospital's strengths and areas for improvement, the surgeons are evaluated separately, thereby improving the accuracy of the assessment.

[0021] (3) The method of the present invention is aimed at preprocessing hysteroscopic videos. It uses time as the first assessment parameter to first distinguish the length of time consumed, and then uses expert review to assess the specific operating skills at different surgical stages, thereby improving the evaluation efficiency and enhancing the operator's awareness of efficiency.

[0022] (4) The method of the present invention first classifies data based on time parameters that are easy for machine processing, which is convenient for subsequent expert review, improves the efficiency and accuracy of the overall evaluation, and can quickly discover the surgeon's advantageous surgical stage, facilitating subsequent promotion and learning.

[0023] (5) The present invention provides a four-quadrant evaluation video classification method, which can quickly understand the difference between the surgeon's surgical skills and the hospital's advantage stage. In particular, it can quickly discover the areas where the hospital has advantages but the surgeon needs to improve, and the areas where the hospital needs to improve but the surgeon has advantages. This can help the surgeon or the hospital to improve in subsequent learning.

[0024] (6) The present invention provides a weighted comprehensive score algorithm, especially assigning a higher weighting coefficient to the part of the hospital that needs to be improved but the surgeon has an advantage, so as to highlight the value of the surgeon's personal skills. BRIEF DESCRIPTION OF THE DRAWINGS

[0025] Figure 1 It is a schematic diagram of the method flow of the present invention; Figure 2 It is a schematic diagram of the four-quadrant classification of the present invention. DETAILED DESCRIPTION

[0026] In order to deepen the understanding of the present invention, the present invention will be further described in detail below in conjunction with examples. The examples are only used to explain the present invention and do not constitute a limitation on the protection scope of the present invention.

[0027] Embodiment 1

[0028] according to Figure 1 As shown, a skill assessment method for laparoscopic surgery operators comprises the following steps: S1. Construct surgical skills assessment indicators; S2. Build a reference video library; organize expert review, select reference videos from previous video materials of similar surgeries, and build a reference video library; S3. Determine the hospital's advantageous surgical stage and the hospital's surgical stage to be improved; calculate the difference between the reference time and the average video time to determine the hospital's advantageous surgical stage and the hospital's surgical stage to be improved; S4, determining the individual's advantageous surgical stage and the individual's surgical stage to be improved; calculating the difference between the reference time and the surgeon's time spent in each surgical stage, and determining the individual's advantageous surgical stage and the individual's surgical stage to be improved; S5. Four-quadrant classification of surgeon evaluation video clips; according to the hospital's advantageous surgical stage, the hospital's surgical stage to be improved, the individual's advantageous surgical stage and the individual's surgical stage to be improved, the surgeon evaluation video clips are classified into four quadrants; S6. Personalized assessment: Organize assessment experts to score and evaluate the skills of the surgeons who are the assessment objects based on the surgeon assessment video clips classified into four quadrants and the assessment indicators.

[0029] Step S2 specifically includes: S21. Determine the surgical procedure as an assessment item based on the type of laparoscopic surgery and divide the surgical procedure into multiple surgical stages ; Among them, the subscript i Indicates the sequence number of the surgical stage, Indicates i The surgical stage represents the reference time of the surgical stage, and I represents the total number of surgical stages; S22. Segment the reference videos of previous surgeries according to the surgical stages to obtain a reference video clip library for multiple surgical stages. ;in, Indicates that for i The first stage of surgery j reference video clips, J represents the total number of reference video clips, and Respectively represent the start time and end time of the reference video segment; S23. Reference video clip library Perform time statistics to obtain a reference time-consuming library ,in, Indicates that for i The time-consuming data function of each surgical stage, , and Respectively based on and The statistically obtained i The reference time mean, reference time lower deviation and reference time upper deviation of each surgical stage meet the following requirements: ; ; ; Among them, min and max represent the minimum value and the maximum value respectively.

[0030] Step S3 specifically includes: S31, based on i Reference time for each surgical stage and the mean reference time , build a reference time deviation evaluation set ,satisfy: ; ; S32, The surgical stage with a positive value is determined as the hospital's dominant surgical stage. The surgical stage with a negative result is determined as the surgical stage to be promoted in this hospital.

[0031] Step S4 specifically includes: S41. Retrieve the surgical videos of the surgeons to be evaluated, and select the cases without complications and erroneous operations as evaluation videos; and divide the evaluation videos into multiple evaluation segments according to the surgical stages. ;in, Indicates that for i The first stage of surgery k evaluation segments of operators, K represents the total number of operators to be evaluated, and Respectively represent the start time and end time of the reference video segment; S42. Calculate the actual time taken for the surgical stage by the surgeon being evaluated , where the subscript represents the serial number of the surgeon being evaluated; satisfies: ; S43. Calculate the difference between the actual time consumed by the operator and the reference time consumed ,satisfy: ; S44. Determine individual time difference The positive and negative nature of S45, The surgical stage with a positive value is determined as the individual advantage surgical stage. The negative surgical stage is determined as the individual's surgical stage to be promoted.

[0032] Step S5 specifically includes: S51. Determine whether the individual's advantageous surgical stage overlaps with the hospital's advantageous surgical stage; S52. Construct a four-quadrant evaluation set; classify the surgeon's evaluation video clips into four quadrants, namely: the first quadrant: evaluation video clips that belong to the individual's advantageous surgical stage and the hospital's advantageous surgical stage; the second quadrant: evaluation video clips that belong to the individual's advantageous surgical stage and the hospital's surgical stage to be improved; the third quadrant: evaluation video clips that belong to the individual's surgical stage to be improved and the hospital's surgical stage to be improved; the fourth quadrant: evaluation video clips that belong to the individual's surgical stage to be improved and the hospital's advantageous surgical stage.

[0033] Evaluation indicators include the surgeon's stability in instrument operation during surgery, instrument positioning accuracy, tissue resection success rate, and operation speed.

[0034] Step S6 specifically includes: the scoring evaluation includes constructing a polynomial weighted scoring function, and the polynomial weighted scoring function is specifically: ; ; Among them, X represents the comprehensive score of the operator's skills. and They represent the weighted coefficient and expert score for the operator in the first quadrant of the surgical stage; and They represent the weighted coefficient and expert score for the operator in the second quadrant of the surgical stage; and They represent the weighted coefficient and expert score for the operator's surgical stage in the third quadrant; and They represent the weighted coefficient and expert score for the surgeon in the fourth quadrant of the surgical stage.

[0035] If the individual time difference If it is negative and its absolute value is smaller than the upper deviation of the reference time consumption, the operation time of the surgeon in this stage of the surgery is considered to be qualified.

[0036] Embodiment 2

[0037] A skill evaluation system for laparoscopic surgeons is used to implement a skill evaluation method for laparoscopic surgeons. The skill evaluation system comprises hysteroscopic surgical equipment, a video storage unit, a video segmentation unit, a timing unit, a four-quadrant classification unit, and an evaluation and scoring unit; the video storage unit is used to store reference videos and evaluation videos; and the video segmentation unit is used to divide the reference videos and the evaluation videos into different surgical stages.

[0038] The above shows and describes the basic principles, main features and advantages of the present invention. It should be understood by those skilled in the art that the present invention is not limited to the above embodiments. The above embodiments and descriptions are only for explaining the principles of the present invention. Without departing from the spirit and scope of the present invention, the present invention may have various changes and improvements, which fall within the scope of the present invention. The scope of protection of the present invention is defined by the attached claims and their equivalents.

Claims

1. A method for evaluating the skill of a laparoscopic surgeon, characterized in that: The following steps are involved: S1. Construct surgical skills assessment indicators; S2, build a reference video library; Organize expert review, select reference videos from previous video materials of similar surgeries, and build a reference video library; S3. Determine the hospital's advantageous surgical stage and the hospital's surgical stage to be improved; calculate the difference between the reference time and the average video time to determine the hospital's advantageous surgical stage and the hospital's surgical stage to be improved; S4, determining the individual's advantageous surgical stage and the individual's surgical stage to be improved; calculating the difference between the reference time and the surgeon's time spent in each surgical stage, and determining the individual's advantageous surgical stage and the individual's surgical stage to be improved; S5. Four-quadrant classification of surgeon evaluation video clips; according to the hospital's advantageous surgical stage, the hospital's surgical stage to be improved, the individual's advantageous surgical stage and the individual's surgical stage to be improved, the surgeon evaluation video clips are classified into four quadrants; S6. Personalized assessment: Organize assessment experts to score and evaluate the skills of the surgeons who are the assessment objects based on the surgeon assessment video clips classified into four quadrants and the assessment indicators.

2. The skill assessment method for laparoscopic surgeons according to claim 1, characterized in that: Step S2 specifically includes: S21. Determine the surgical procedure as the assessment item according to the type of laparoscopic surgery, and divide the surgical procedure into multiple surgical stages ; Among them, the subscript i Indicates the sequence number of the surgical stage, Indicates i The surgical stage represents the reference time of the surgical stage, and I represents the total number of surgical stages; S22, according to the surgical stage, the reference video of the previous surgery is segmented to obtain a reference video clip library of multiple surgical stages ;in, Indicates that for i The first stage of surgery j reference video clips, J represents the total number of reference video clips, and Respectively represent the start time and end time of the reference video segment; S23, the reference video clip library Perform time statistics to obtain a reference time-consuming library ,in, Indicates that for i The time-consuming data function of each surgical stage, , and Respectively based on and The statistically obtained i The reference time mean, reference time lower deviation and reference time upper deviation of each surgical stage meet the following requirements: ； ； ； Among them, min and max represent the minimum value and the maximum value respectively.

3. The skill assessment method for laparoscopic surgeons according to claim 2, characterized in that: Step S3 specifically includes: S31, based on i Reference time for each surgical stage and the reference time average , build a reference time deviation evaluation set ,satisfy: ； ； S32, The surgical stage with a positive value is determined as the hospital's dominant surgical stage. The surgical stage with a negative result is determined as the surgical stage to be promoted in this hospital.

4. The skill assessment method for laparoscopic surgeons according to claim 3, characterized in that: Step S4 specifically includes: S41. Retrieve the surgical videos of the surgeons to be evaluated, and select the cases without complications and erroneous operations as evaluation videos; and divide the evaluation videos into multiple evaluation segments according to the surgical stages. ;in, Indicates that for i The first stage of surgery k evaluation segments of operators, K represents the total number of operators to be evaluated, and Respectively represent the start time and end time of the reference video segment; S42. Calculate the actual time taken for the surgical stage by the surgeon being evaluated , where the subscript represents the serial number of the surgeon being evaluated; satisfies: ； S43. Calculate the difference between the actual time consumed by the operator and the reference time consumed ,satisfy: ； S44. Determine individual time difference The positive and negative nature of S45, The surgical stage with a positive value is determined as the individual advantage surgical stage. The negative surgical stage is determined as the individual's surgical stage to be promoted.

5. The skill assessment method for laparoscopic surgeons according to claim 4, characterized in that: Step S5 specifically includes: S51. Determine whether the individual's advantageous surgical stage overlaps with the hospital's advantageous surgical stage; S52, constructing a four-quadrant evaluation set; classifying the operator's evaluation video clips according to the four quadrants, namely: Quadrant 1: Evaluation video clips that belong to the individual's advantage surgical stage and the hospital's advantage surgical stage; The second quadrant: evaluation video clips that belong to the stage of surgery that is the individual's advantage and the stage of surgery that needs to be improved in the hospital; The third quadrant: evaluation video clips that belong to the individual's pending surgery stage and the hospital's pending surgery stage; The fourth quadrant: evaluation video clips that belong to the individual's surgery stage for improvement and the hospital's advantage surgery stage.

6. The skill assessment method for laparoscopic surgery according to any one of claims 1 to 5, characterized in that: The evaluation indicators include the operator's stability in instrument operation during the operation, instrument positioning accuracy, tissue resection success rate, and operation speed.

7. The skill assessment method for laparoscopic surgeons according to claim 5, characterized in that: Step S6 specifically includes: the scoring evaluation includes constructing a polynomial weighted scoring function, and the polynomial weighted scoring function is specifically: ； ； Among them, X represents the comprehensive score of the operator's skills. and They represent the weighted coefficient and expert score for the operator in the first quadrant of the surgical stage; and They represent the weighted coefficient and expert score for the operator in the second quadrant of the surgical stage; and They represent the weighted coefficient and expert score for the operator in the third quadrant of the surgical stage; and They represent the weighted coefficient and expert score for the surgeon in the fourth quadrant of the surgical stage.

8. The skill assessment method for laparoscopic surgeons according to claim 5, characterized in that: Step S6 also includes: if the individual time difference If it is negative and its absolute value is smaller than the upper deviation of the reference time consumption, it is considered that the operation time of the surgeon in this stage of the operation is qualified.

9. A skill evaluation system for laparoscopic surgeons, used for implementing the skill evaluation method for laparoscopic surgeons as claimed in any one of claims 1 to 5, characterized in that: The skill evaluation system includes hysteroscopic surgical equipment, a video storage unit, a video segmentation unit, a timing unit, a four-quadrant classification unit, and an evaluation scoring unit; the video storage unit is used to store reference videos and evaluation videos; the video segmentation unit is used to divide the reference videos and evaluation videos into different surgical stages.

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