{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T15:17:01Z","timestamp":1783696621996,"version":"3.55.0"},"reference-count":6,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001695","name":"Japan Science and Technology Corporation","doi-asserted-by":"publisher","award":["2015-PM15-11-01"],"award-info":[{"award-number":["2015-PM15-11-01"]}],"id":[{"id":"10.13039\/501100001695","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J CARS"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Objective assessment of robotic surgical skills is particularly important in pediatric surgery, where limited case volume restricts training opportunities. This study presents a virtual reality (VR)-based framework for automated evaluation of robotic suturing skills in a neonatal surgical scenario and investigates its agreement with expert video-based assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A real-time VR simulator was developed to emulate neonatal robotic suturing with the SmartArm system. An automated skills assessment module was implemented using an 11-point subset of a validated 29-point suturing checklist. Each checklist item was reformulated into quantitative geometric and kinematic criteria directly extracted from the simulation . Ten suturing trials were recorded and independently evaluated by an expert pediatric surgeon using video review. Automated scores were compared with expert scores using accuracy, precision, recall, and F1-score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The simulator enabled stable real-time execution of robotic suturing tasks and deterministic extraction of performance metrics. The automated assessment achieved an accuracy of 67.3%, with a precision of 0.933, recall of 0.560, and F1-score of 0.700 relative to expert evaluation. Higher agreement was observed for clearly defined metrics, while discrepancies were primarily associated with criteria dependent on visual judgment in 2D video assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>VR-based automated assessment of robotic pediatric suturing is feasible and provides objective, repeatable evaluation of performance. By translating clinically defined checklist items into measurable simulation-derived parameters, the proposed framework offers a scalable alternative to manual video-based skills assessment in robotic surgery training.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11548-026-03659-3","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T09:46:16Z","timestamp":1777542376000},"page":"1109-1112","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["VR-based automated suturing skill assessment in pediatric robotic surgery"],"prefix":"10.1007","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1812-8649","authenticated-orcid":false,"given":"Saul Alexis","family":"Heredia Perez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enduo","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murilo","family":"Marques Marinho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyoichi","family":"Deie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mamoru","family":"Mitsuishi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanako","family":"Harada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"issue":"3","key":"3659_CR1","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1093\/icvts\/ivu406","volume":"20","author":"Q Ballouhey","year":"2015","unstructured":"Ballouhey Q, Villemagne T, Cros J, Vacquerie V, B\u00e9renguer D, Braik K, Szwarc C, Longis B, Lardy H, Fourcade L (2015) Assessment of paediatric thoracic robotic surgery. Interact Cardiovasc Thorac Surg 20(3):300\u2013303","journal-title":"Interact Cardiovasc Thorac Surg"},{"issue":"6","key":"3659_CR2","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1002\/micr.20766","volume":"30","author":"H Kazemi","year":"2010","unstructured":"Kazemi H, Rappel JK, Poston T, Hai Lim B, Burdet E, Leong Teo C (2010) Assessing suturing techniques using a virtual reality surgical simulator. Microsurgery 30(6):479\u2013486","journal-title":"Microsurgery"},{"issue":"1","key":"3659_CR3","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1186\/s12894-015-0051-4","volume":"15","author":"MA Liss","year":"2015","unstructured":"Liss MA, Kane CJ, Chen T, Baumgartner J, Derweesh IH (2015) Virtual reality suturing task as an objective test for robotic experience assessment. BMC Urol 15(1):63","journal-title":"BMC Urol"},{"key":"3659_CR4","doi-asserted-by":"publisher","unstructured":"Moorthy K, Munz Y, Dosis A, Bello F, Chang A, Darzi A (2004) Bimodal assessment of laparoscopic suturing skills. Surg Endosc 18(11):1608\u20131612. https:\/\/doi.org\/10.1007\/bf02637130","DOI":"10.1007\/bf02637130"},{"issue":"1","key":"3659_CR5","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1109\/TMRB.2021.3049878","volume":"3","author":"MM Marinho","year":"2021","unstructured":"Marinho MM, Harada K, Deie K, Ishimaru T, Mitsuishi M (2021) Smartarm: suturing feasibility of a surgical robotic system on a neonatal chest model. IEEE Trans Med Robot Bion 3(1):253\u2013256","journal-title":"IEEE Trans Med Robot Bion"},{"key":"3659_CR6","doi-asserted-by":"publisher","unstructured":"Deie K, Ishimaru T, Takazawa S, Harada K, Sugita N, Mitsuishi M, Fujishiro J, Iwanaka T (2017) Preliminary study of video-based pediatric endoscopic surgical skill assessment using a neonatal esophageal atresia\/tracheoesophageal fistula model. J Laparoend Adv Surg Techn 27(1):76\u201381. https:\/\/doi.org\/10.1089\/lap.2016.0214","DOI":"10.1089\/lap.2016.0214"}],"container-title":["International Journal of Computer Assisted Radiology and Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11548-026-03659-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11548-026-03659-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11548-026-03659-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T14:55:42Z","timestamp":1783695342000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11548-026-03659-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,30]]},"references-count":6,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["3659"],"URL":"https:\/\/doi.org\/10.1007\/s11548-026-03659-3","relation":{},"ISSN":["1861-6429"],"issn-type":[{"value":"1861-6429","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,30]]},"assertion":[{"value":"21 February 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 April 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All procedures involving human participants were performed in accordance with the ethical standards and guidelines of the University of Tokyo. Informed consent was obtained from all individual participants included in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}