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Video

Professional and Personal Development

(A1023) Quantified Assessment of Resident Motion During Endoscopic Sphenoidotomy

Monday, October 13, 2025
12:00 PM - 1:00 PM EDT
Location: OTO EXPO, Posters

    Presenting Author(s)

  • Emma D. Ryan, MD

    Resident
    University of Rochester
    Rochester, New York, United States

    • Co-Author(s)

  • AK

    Andrew P. Kelly, MD

    University of Rochester, United States

  • Yangming Lee, PhD

    Assistant Professor
    Rochester Institute of Technology
    Rochester, New York, United States

  • Li-Xing Man, MSc, MD, MPA

    Associate Professor of Otolaryngology and Associate DIO
    University of Rochester Medical Center
    Pittsford, NY, United States

    • Senior Author(s)

  • Isaac L. Schmale, MD, FARS

    Assistant Professor
    University of Rochester Medical Center
    Rochester, New York, United States

Disclosure(s):
Emma D. Ryan, MD: No relevant relationships to disclose.
Yangming Lee, PhD: No relevant relationships to disclose.
Isaac L. Schmale, MD, FARS: No relevant relationships to disclose.


Introduction: Feedback of technical skills given to surgical trainees is often qualitative and lacking in specificity on how to improve. Understanding nuances in surgeon motion may help learners more readily assimilate technical skills. We sought to determine whether endoscope and instrument motion tracking metrics are associated with competency in endoscopic sinus surgery.

Methods: Ten bilateral sphenoidotomy procedures at a single institution were identified. Expert (attending) surgeons were randomized to perform the procedure on one side while trainee (resident) surgeons performed the contralateral side. Total time and distance, idle time (speed of
< 20 mm/s for ≥0.5 s), and average distance and angle between instruments were tracked using Stryker Scopis navigation technology. After each procedure, attending and resident surgeons rated case difficulty and surgeon performance.

Results: Motion tracking data were collected from two expert and three trainee surgeons. Mean idle time of selected instruments (38.0 vs. 82.5 s, p=0.035) and total path length of both the scope and instruments (1880.9 vs. 2864.6 cm, p=0.013) were significantly less for experts compared to
trainees. The mean distance and angle between the endoscope and a given instrument were not significantly different (19.5 vs 19.7 cm, p=0.15 and 102.5 vs. 99.1 degrees, p=0.29). Attending ratings of overall resident performance were weakly correlated with idle time (R=-0.22) and moderately correlated with total path length (R=-0.58).

Conclusions: Expert and trainee surgeons can be reliably distinguished during sphenoidotomy using motion tracking technology. Total distance moved by the trainee’s instruments is associated with overall performance, suggesting that this metric may be used by residents to track their progression.
Further study is needed to create and validate an evaluation tool that can be used in a real-world setting. Motion tracking technology may eventually facilitate improvements in quantity and quality of feedback for learners, as well as more reliable assessment of the efficacy
of educational interventions in future scholarship.