In Orthopaedics & traumatology, surgery & research : OTSR
INTRODUCTION : In order to be used naturally and widely, an artificial intelligence algorithm of phase detection in surgical videos presupposes an expert consensus defining phases.
OBJECTIVES : The aim of the present study was to seek consensus in defining the various phases of a surgical technique in wrist traumatology.
METHODS : 3,229 surgeons were sent a video showing anterior plate fixation of the distal radius and a questionnaire on the number of phases they distinguished and the visual cues signaling the beginning of each phase. Three experimenters predefined the number of phases (5: installation, approach, fixation, verification, closure) and sub-phases (3a: introduction of plate; 3b: positioning distal screws; 3c: positioning proximal screws) and the cues signaling the beginning of each. The numbers of the responses per item were collected.
RESULTS : Only 216 (6.7%) surgeons opened the questionnaire, and 100 answered all questions (3.1%). Most respondents claimed 5/5 expertise. Number of phases identified ranged between 3 and 10. More than two-thirds of respondents identified the same phase cue as defined by the 3 experimenters in most cases, except for "verification" and "positioning proximal screws".
DISCUSSION : Surgical procedures comprise a succession of phases, the beginning or end of which can be defined by a precise visual cue on video, either beginning with the appearance of the cue or the disappearance of the cue defining the preceding phase.
CONCLUSION : These cues need to be defined very precisely before attempting manual annotation of surgical videos in order to develop an artificial intelligence algorithm.
LEVEL OF EVIDENCE : II.
Graëff Camille, Daiss Audrey, Lampert Thomas, Padoy Nicolas, Martins Antoine, Sapa Marie-Cécile, Liverneaux Philippe
2023-Jan-23
algorithm, artificial intelligence, distal radius fracture, phase detection, surgical video
