Can Microinstrument Motion Metrics of Distance, Speed, and Acceleration Indicate Surgical Task Complexity? An AI-Driven Study.

Objectifying the quality of microsurgical technique is both crucial and challenging. The aim of this study was to evaluate whether microinstrument motion metricscan reflect the complexity of microsurgical tasks. The laboratory experiment involved 13 right-handed neurosurgeons tasked with using microsurgical scissors to cut a white thread at a spot marked by a purple dot under the microscope. Each participant completed the task under four consecutive conditions: with or without wrist stabilization on a support, both before and after muscle load. Using the promptable transformer model, we segmented microsurgical instruments from video recordings and extracted their skeletons and centers of mass. From the time series of the center of mass X and Y coordinates, we derived seven additional time series for velocity, acceleration, and the jerk along the X and Y axes, as well as the smoothness metric. We generated thirty-three statistical features for each time series using the feasts R package. These motion features were then compared pairwise across various tasks. Of the 1782 tests conducted, 164 (or 9.2%) revealed statistically significant differences in 66 motion features. Our results provide a proof-of-concept, showing that AI-derived microsurgical motion features can reflect the complexity of conditions encountered by the microsurgeon during surgery.