biostudies-literatureMa RU.S. Department of Health & Human Services | NIH | National Cancer InstituteNCI NIH HHS187https://www.ebi.ac.uk/biostudies/studies/S-EPMC9780308biostudies-literatureUnknown5(1)How well a surgery is performed impacts a patient's outcomes; however, objective quantification of performance remains an unsolved challenge. Deconstructing a procedure into discrete instrument-tissue "gestures" is a emerging way to understand surgery. To establish this paradigm in a procedure where performance is the most important factor for patient outcomes, we identify 34,323 individual gestures performed in 80 nerve-sparing robot-assisted radical prostatectomies from two international medical centers. Gestures are classified into nine distinct dissection gestures (e.g., hot cut) and four supporting gestures (e.g., retraction). Our primary outcome is to identify factors impacting a patient's 1-year erectile function (EF) recovery after radical prostatectomy. We find that less use of hoNPJ digital medicineSurgical gestures as a method to quantify surgical performance and predict patient outcomes.PMC9780308R01 CA273031R01CA273031Urbanova KHu JCMa RWagner COtiato MXWong EYRodriguez IHung AJLaca JChu TNAnandkumar AKiyasseh DXu JDeMeo GNguyen JHLiu YRamaswamy ADesai ALee RSTrinh LRoberts SIfalseSurgical gestures as a method to quantify surgical performance and predict patient outcomes.How well a surgery is performed impacts a patient's outcomes; however, objective quantification of performance remains an unsolved challenge. Deconstructing a procedure into discrete instrument-tissue "gestures" is a emerging way to understand surgery. To establish this paradigm in a procedure where performance is the most important factor for patient outcomes, we identify 34,323 individual gestures performed in 80 nerve-sparing robot-assisted radical prostatectomies from two international medical centers. Gestures are classified into nine distinct dissection gestures (e.g., hot cut) and four supporting gestures (e.g., retraction). Our primary outcome is to identify factors impacting a patient's 1-year erectile function (EF) recovery after radical prostatectomy. We find that less use of ho2022-01-01T00:00:00Z2022 Dec2025-04-04T08:45:03.302Z2025-04-04T08:45:03.302ZS-EPMC97803083655020310.1038/s41746-022-00738-y