Video assessment of a surgical procedure using AI

AI for surgical education: a call to test our new Strava-for-Surgeons

by Ritsaart van Montfrans, CEO at Incision


We’re making great progress in using AI for surgical education. This blog will give you an update on our video assessment work, and if you’re up for it we will invite you to test our new features! 

Improving your game

Many sports teams and athletes use video analysis. Looking at their own performance, analysing it and using it to become better at their game. 

So, why not in surgery? Laparoscopic and robotic videos of surgical procedures are increasingly becoming available. Sometimes it can be a bit of work to overcome the technical hurdles. Or to arrange patient consent. But it’s becoming more and more accepted. 

And, there are good reasons to apply it for surgical education. Surgical residents need to master a range of surgical procedures during their training. For some of the core procedures this means that they need to build their skills during 30+ surgeries. So, providing feedback on performance can be a powerful tool. 

However, assessing a video can be a time consuming task. The duration of a video can range from 30 minutes to hours. Moreover, you do not always know what aspects you should pay attention to. The traction on the tissue? The bimanual dexterity? Preventing small injury? How would a great surgeon do this? 

Incision’s solution

At Incision we work in many countries around the world to support resident education. A number of residents have asked us if we can support them by providing feedback on their surgical videos. So, of course we went to work on this and we created the tool - like the runner App Strava, but now in the form of a guidance tool to accelerate surgical education.

Following a number of iterations and prototypes, we have now created a great first release. Not only analysing performance, but also providing good feedback on how to improve the next time you operate. And all of this in a structured, standardised, and personalised fashion. 

We use a set of metrics in our tool to give you feedback on your performance:

  • CAT, or a Competency Assessment Tool. An objective assessment tool, validated to assess the quality of execution of a surgical procedure. Per step of the procedure, an assessment is made of the Exposure, Execution, Adverse events and End product quality 
  • Key Error Evaluation. Using the OCHRA methodology, an assessment is made if any of the 'most common’ errors are made during the procedure
  • GOALS. A validated assessment tool for grading overall technical proficiency for laparoscopic surgery

And in addition, we give the following feedback in the assessment report: 

  • Expert feedback: Valuable feedback from a surgeon on the performance by step of the procedure
  • Tips Clips. Based on the assessment of the resident’s performance, we provide specific video clips that show the relevant learning points for a resident 

To do all this we use different forms of AI. For example, we are able to detect over 30 instruments that are used in the most prevalent laparoscopic surgeries. And we de-identify all the videos.

Using AI to identify important moments during a surgical procedureImportant moment during a surgical procedure based on movement


Also, we developed an auto-navigation feature that directs you - or your assessor - to the key moments in a procedure. Have you ever searched in a YouTube video to find a specific moment, clicking back and forth in time until you found it? Yes, we know that is a tedious/annoying task, and we want to make your assessment way more efficient. Most of the items on the pre-defined metrics as described above can be assessed by reviewing the actions that take place during a set of key moments. Based on our unique AI measures, we are able to identify at which time points these moments take place. Imagine clicking through the important steps in a video, instead of spending a lot of time clicking back and forth to find the moment you are looking for. 

Want to test it with us? 

We are looking for residents to try out our latest video feedback tools. Curious to see the technology in action? Please send us a DM if you would like to work with us on this (vergouwen@incision.care), and improve your game. We are starting with Lap Cholecystectomy for this, so reach out to us if you have just started working on this procedure. We will limit the initial phase to a small number of participants, first come first serve!

Curious what Incision's surgical e-learning platform can do for your hospital?

The Incision Academy contains over 500 high-quality video courses on surgical procedures to prepare for your work. Explore surgical procedures step by step in 2D & 3D, master basic principles and skills, anatomy, medical technology, and much more. We bring together everything that’s required to optimize OR performance.

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