317 Analysis of the video motion tracking system ‘Kinovea’ to assess surgical movements during robot-assisted radical prostatectomy. Discussion The aim of this study was to determine whether Kinovea is a valid tool for automated surgical movements tracking in RARP and if results could be used to evaluate a possible relation between surgical movements and postoperative urinary continence after RARP. The value of automated assessment of surgical movements in RARP surgical videos using Kinovea To answer if Kinovea is a valid tool for assessment of surgical movements in RARP surgical videos an analysis of 12 entire RARP procedures was performed by a trained researcher. The analysis itself was not technically challenging, after manual calibration, the researcher only had to position the tracking point on the most distal hinge of the instrument and press play. During automated analysis the videos had to be manually adjusted since Kinovea was frequently not able to run fully automatic. In most instances the short distance between camera and tissue (level of zoom), the speed of the surgical instruments, tissue overlapping the instrument and the fact that the instrument has flexible joints, made it difficult to track the instrument correctly. These findings show that it is difficult to use Kinovea for assessment of surgical movements in RARP surgical videos. The group of Ganni, et al. was able to automatically track the instrument during surgery with Kinovea. They checked a few minutes manually per video in order to confirm their results.9 We attempted to perform similar analysis in robot assisted surgery as in the study of Ganni, et al. The analysis was based on the same principal by relating the distance moved by the surgical instrument to the relative measurements of the instrument. In our study the frequent manual adjustments raised the need for continued monitoring by the researcher, this meant it was a very time-consuming method of analysis. In this study we compared two forms of output from the Kinovea program, one form is the automated results (automated output) given by the Kinovea program, the other form of output was the calculated results based on the raw Kinovea data using the formulas as described in the study by Ganni, et al (manual output). An interesting finding was the lack of sudden movements reported in the videos when using the automated output, which did not match the number of sudden movements found using the manual calculations based on the formulas used by Ganni, et al.9 The automated and manual total path length and average speed also did not match. These inconsistencies raise the questions why the outputs differ and which method
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