A Step Toward Identification of Surgical Actions in Mastoidectomy

Mastoidectomy is a core surgical procedure in otologic surgery. It is believed that the procedure is performed by different surgeons with some variability. However, it is also believed that all surgeons use a finite number of fundamental surgical actions to complete the procedure. To determine how a surgeon performs a mastoidectomy, we sought to identify the fundamental surgical actions called action primitives (APs) and determine the transition boundaries among those APs. Our motivation for this paper is both to delineate the APs necessary to complete a mastoidectomy and to optimize and potentially automate the surgical process. In this paper, we present a new approach to developing methods for parsing raw data (position and orientation of the surgical tool and end-effector force) into a sequence of surgical tasks. The overall objective is to deconstruct the surgical procedure into a series of APs. This paper presents results from our initial investigation on detecting transition boundaries and identifying APs involved in mastoidectomy.