Energy dashboard: post-operative insights into electrosurgical device use

Background: This study presents a post-operative energy dashboard to teach surgeons about electrosurgical device use. By analyzing the energy generator, we aim to add new information to the current assessment of surgical skills. This study evaluated how such a dashboard can provide insight into differences in electrosurgery application.

Methods: A semi-automated methodology for the energy dashboard was developed by acquiring intra-operative energy generator and video data, and computing metrics to compare device use. The energy dashboard quantified the use of the electrosurgical device based on the number of activations (N), the duration of individual activations (s), the total use time (s), and the total applied energy (kJ). The methodology and differences in device use were assessed based on forty-eight fundoplication surgeries performed by three surgeons.

Results: The methodology identified the device activations with an F1-score of 0.95. The comparison between the surgeons showed significant differences in total usage, turn-on count, and amount of applied energy. In addition, the dashboard showed a significant difference in total applied energy (kJ) over the dissections of the gastrohepatic and gastrosplenic ligament.

Conclusion: The study showed that energy monitoring can provide insights into application differences. In addition, the pilot study showed that the use of electrosurgical devices can differ significantly between surgeons. A broader application of the energy dashboard can enable a new source of information for surgical skill assessment.