Abstract

PurposeIn laparoscopic surgery training, experts guide novice physicians to desired instrument positions or indicate relevant areas of interest. These instructions are usually given via verbal communication or using physical pointing devices. To facilitate a sterile work flow and to improve training, new guiding methods are needed. This work proposes to use optical see-through augmented reality to visualize an interactive virtual pointer on the laparoscopic.MethodsAfter an interdisciplinary development, the pointer’s applicability and feasibility for training was evaluated and it was compared to a standard condition based on verbal and gestural communication only. In this study, ten surgical trainees were guided by an experienced trainer during cholecystectomies on a laparoscopic training simulator. All trainees completed a virtual cholecystectomy with and without the interactive virtual pointer in alternating order. Measures included procedure time, economy of movement and error rates.ResultsResults of standardized variables revealed significantly improved economy of movement (p = 0.047) and error rates (p = 0.047), as well as an overall improved user performance (Total z-score; p = 0.031) in conditions using the proposed method.ConclusionThe proposed HoloPointer is a feasible and applicable tool for laparoscopic surgery training. It improved objective performance metrics without prolongation of the task completion time in this pre-clinical setup.

Highlights

  • IntroductionFlorian Heinrich and Florentine Huettl contributed as first authors

  • Florian Heinrich and Florentine Huettl contributed as first authors.Tobias Huber and Christian Hansen contributed as last authors.Electronic supplementary material The online version of this article contains supplementary material, which is available to authorized users.University Medicine of the Johannes Gutenberg University Mainz, Mainz, Germany 4 Department of Surgery, Hospital St

  • Significant effects were shown regarding the overall summary score variable, indicating that use of the HoloPointer was generally advantageous compared to the standard condition

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Summary

Introduction

Florian Heinrich and Florentine Huettl contributed as first authors. Tobias Huber and Christian Hansen contributed as last authors. Advantages of minimally invasive surgery are a reduced risk of infection, a shorter hospital stay and recovery time. These benefits are accompanied by technical difficulties like having spatially separated monitors instead of direct vision on the patient and the operation site [1]. This mentally demanding psychomotor task complicates handeye-coordination and leads to perceptual issues regarding the correct position of instruments and patient anatomy [2,3,4]

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