Kinematic-Based Assessment of Surgical Actions in Microanastomosis

Proficiency in microanastomosis is a critical surgical skill in neurosurgery, where the ability to precisely manipulate fine instruments is crucial to successful outcomes. These procedures require sustained attention, coordinated hand movements, and highly refined motor skills, underscoring the need for objective and systematic methods to evaluate and enhance microsurgical training. Conventional assessment approaches typically rely on expert raters supervising the procedures or reviewing surgical videos, which is an inherently subjective process prone to inter-rater variability, inconsistency, and significant time investment. These limitations highlight the necessity for automated and scalable solutions. To address this challenge, we introduce a novel AI-driven framework for automated action segmentation and performance assessment in microanastomosis procedures, designed to operate efficiently on edge computing platforms. The proposed system comprises three main components: (1) an object tip tracking and localization module based on YOLO and DeepSORT; (2) an action segmentation module leveraging self-similarity matrix for action boundary detection and unsupervised clustering; and (3) a supervised classification module designed to evaluate surgical gesture proficiency. Experimental validation on a dataset of 58 expert-rated microanastomosis videos demonstrates the effectiveness of our approach, achieving a frame-level action segmentation accuracy of 92.4% and an overall skill classification accuracy of 85.5% in replicating expert evaluations. These findings demonstrate the potential of the proposed method to provide objective, real-time feedback in microsurgical education, thereby enabling more standardized, data-driven training protocols and advancing competency assessment in high-stakes surgical environments.