Date of Award

5-2024

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Bioengineering

Committee Chair/Advisor

Dr. Ravikiran Singapogu

Committee Member

Dr. Richard E. Groff

Committee Member

Dr. Joe Bible

Committee Member

Dr. John F. Eidt

Committee Member

Dr. Jordon Gilmore

Abstract

Vascular surgery demands highly skilled suturing to manipulate and connect delicate vasculature. However, inadequate methods for open suturing skills training necessitate efficient and objective methods to develop skills. To address this need, medical training simulators for objective surgical skills training are gaining popularity for their formative assessment.

This research details the development of a system to classify suturing performance and provide feedback on a suturing skills measurement and feedback platform (called the SutureCoach). The SutureCoach simulator offers a comprehensive assessment of skill through sensors measuring needle driver motions, membrane forces and torques, subcutaneous suture needle movement, and hand motions. We analyzed suturing trial performance on an extensive dataset of 97 subjects with varying clinical expertise. This research will first focus on the development of sensor-based metrics derived from needle driver motions and membrane forces and torque. These metrics successfully differentiated group metric scores between novices (no medical experience), intermediates (residents), and experts (attending surgeons/fellows). To further validate sensor metrics’ relevance, these metrics were compared with expert assessments of SutureCoach trials, including metrics derived from suture needle movement and hand motions. Several metrics that effectively differentiated group scores also demonstrated significant associations with expert assessment.

These results were incorporated into a machine learning algorithm to classify performance. The developed algorithm then presents a proof-of-concept method to provide feedback based on specific suture performance to the user. This research emphasizes the importance of comprehensive, multi-modal skill assessment for a more holistic evaluation of suturing.

Author ORCID Identifier

0009-0001-8755-6866

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