Analysis of the structure of surgical activity for a suturing and knot-tying task

S. Swaroop Vedula, Anand O. Malpani, Lingling Tao, George Chen, Yixin Gao, Piyush Poddar, Narges Ahmidi, Christopher Paxton, Rene Vidal, Sanjeev Khudanpur, Gregory D. Hager, Chi Chiung Grace Chen

Research output: Contribution to journalArticlepeer-review


Background Surgical tasks are performed in a sequence of steps, and technical skill evaluation includes assessing task flow efficiency. Our objective was to describe differences in task flow for expert and novice surgeons for a basic surgical task. Methods We used a hierarchical semantic vocabulary to decompose and annotate maneuvers and gestures for 135 instances of a surgeon's knot performed by 18 surgeons. We compared counts of maneuvers and gestures, and analyzed task flow by skill level. Results Experts used fewer gestures to perform the task (26.29; 95% CI = 25.21 to 27.38 for experts vs. 31.30; 95% CI = 29.05 to 33.55 for novices) and made fewer errors in gestures than novices (1.00; 95% CI = 0.61 to 1.39 vs. 2.84; 95% CI = 2.3 to 3.37). Transitions among maneuvers, and among gestures within each maneuver for expert trials were more predictable than novice trials. Conclusions Activity segments and state flow transitions within a basic surgical task differ by surgical skill level, and can be used to provide targeted feedback to surgical trainees.

Original languageEnglish (US)
Article numbere0149174
JournalPloS one
Issue number3
StatePublished - Mar 2016

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General


Dive into the research topics of 'Analysis of the structure of surgical activity for a suturing and knot-tying task'. Together they form a unique fingerprint.

Cite this