Xpert Hands

Xpert Hands is a wrist sensor and smartphone application which would be benchmarked with the hands of expert microsurgeons while they perform microsurgery. This device would then be used to track, pace and evaluate hand eye coordination, knot tying and vessel anastomosis during practice on a physical model. The outputs-goodness of fit to standard, time taken to complete tasks, pulse rate of trainee, would be readable graphically on the application. A modified Objective Structured Assessment of Technical Skills (OSATS) would be embedded into the app. The option of video recording of the procedure would be available to the trainee. All trainees who assess the app would have a unique identification. All output readings would be available for review at the co ordinating centre. The trainee may decide to be self paced or be paced by the coordinating centre. The device would enable a virtual microsurgery skills training.

Xpert Hands is a microsurgery skills training module. It is somewhat like a GPS tracking device used for persons on house arrest only this time the hands of trainees during the performance of key microsurgery skills are will be tracked. The device would be able to determine out of range motions and distances as a result of prior standardization by hands of expert microsurgeons. Xpert Hands is being designed with wearable data technology, artificial intelligence and machine leaning models. Xpert Hands is also leveraging on the current uptake of virtual platforms for training as a fall out of the COVID 19 pandemic. 

Hand eye coordination, knot tying, vessel anastomosis and speed of performing tasks are the target skills. The current modality of basic surgical skills training and flap and microsurgery skills training has surgical trainees in West Africa needing to plan ahead for the course, obtain necessary permissions, secure costs for travel and course fees in order to participate in the program. These courses are approved by the West African College of surgeons as a component of the trainees curricular. The flap and microsurgery course takes place every two years. As stated by Donaghy in 1979 on microsurgery, "a first experience has no place in the operating room".  Constant practice for perfection is required which the infrequent nature (due to fund and logistics constraints) of the course cannot deliver. It is therefore not surprising that microsurgery reconstruction is still abysmal in sub Saharan Africa. The high burden of debilitating trauma and cancers, that require complex reconstructions for either saving life, limb or improving quality of life makes the need for increased practice of microsurgery and increased competences in this skill huge. 

Trainees practicing with Xpert Hands would be expected to use loupe magnification which can be used in the operating room.

Reconstructive (plastic, cardiothoracic , otorhinolarygology, orthopaedic, maxillofacial), surgical trainees routinely enroll for a flap and microsurgery at the coordinating centre held every two years. This concept/pilot phase would be for these trainees. One clear feedback from the trainees is that the course is not frequent enough to develop and maintain the skills required for microsurgery as well as the lack of operating microscopes or bench top microscopes(used in the course) for continued learning. Trainees from distant and conflict rife states find it difficult to make the journey to the course centre. Microsurgery can be performed under loupe magnification. All trainees should have operating loupes and are encouraged to procure this and use them routinely in non microsurgery related surgeries such as hand surgery and flap surgery.

This project would enable virtual microsurgery skills training initially twice a year by the coordinating centre and more frequently by the trainee. We envision in the long term a significant positive impact to the uptake of microsurgical reconstruction.

Following the success of this phase all reconstructive surgeons would be encouraged to have Xpert Hands. It also has the potential to be scalable for use by medical students in the acquisition of basic surgical skills.

• Afieharo Michael-  Plastic Surgeon (Nigeria) Team Lead/ Co ordinator/Field testing
• Olayinka Olawoye  Plastic Surgeon (Nigeria) Educator/Field testing
• Geogette Oni Plastic Surgeon( Uk) Educator/ Benchmarking
• Adeyemi Ogunleye  Plastic Surgeon (USA) -Educator/ Benchmarking
• Chihena Banda Plastic Surgeon (Japan) Benchmarking
• Rudo  Madada-Nyakauru Plastic Surgeon (Uk) Benchmarking
• Bolanle Oladejo  Software Engineering/Artificial Intelligence (Nigeria) -Tech expert
• Oluwasola Adeniji - Computational intelligence/Machine learning (Nigeria) Tech expert
• Richard Igbape -Graphic design/Information technology (Nigeria)-Tech Expert.
• Olajide Oladejo- Computer vision research, software developer- Tech expert
• Ifeoluwatayo Adeseye Ige-Computer graphic processing-Tech team
• Samuel Ademola Plastic Surgeon. Head Department of Plastic Surgery UCH, Ibadan, Nigeria-Facilitation of administrative and institutional permissions/contracts.
• Odunayo Oluwatosin- Professor, Plastic surgery- Founder of the flap and microsurgery course. Facilitation of institutional permissions and facilitation of uptake by the training colleges in Nigeria and West Africa.
• Samuel O. Poore- Associate Professor of Surgery, Division of Plastic Surgery, Department of Surgery. University of Wisconsin School of Medicine and Public Health-Team Consultant

A Mentor/Adviser versed in wearable technologies and simulation based assessments