Abstract
Purpose Surgical navigation systems rely on a monitor placed in the operating room to relay information. Optimal monitor placement can be challenging in crowded rooms, and it is often not possible to place the monitor directly beside the situs. The operator must split attention between the navigation system and the situs. We present an approach for needle-based interventions to provide navigational feedback directly on the instrument and close to the situs by mounting a small display onto the needle.Methods By mounting a small and lightweight smartwatch display directly onto the instrument, we are able to provide navigational guidance close to the situs and directly in the operator’s field of view, thereby reducing the need to switch the focus of view between the situs and the navigation system. We devise a specific variant of the established crosshair metaphor suitable for the very limited screen space. We conduct an empirical user study comparing our approach to using a monitor and a combination of both.Results Results from the empirical user study show significant benefits for cognitive load, user preference, and general usability for the instrument-mounted display, while achieving the same level of performance in terms of time and accuracy compared to using a monitor.Conclusion We successfully demonstrate the feasibility of our approach and potential benefits. With ongoing technological advancements, instrument-mounted displays might complement standard monitor setups for surgical navigation in order to lower cognitive demands and for improved usability of such systems.
Highlights
Surgical navigation systems are becoming more common throughout different disciplines, often used for operations and interventions involving very delicate structures, structures that are not perceivable without medical imagery, and for minimally invasive interventions where the natural field of view of the operator is limited.This work focuses on needle-based interventions
Results from the empirical user study show significant benefits for cognitive load, user preference, and general usability for the instrument-mounted display, while achieving the same level of performance in terms of time and accuracy compared to using a monitor
As shown by the significant differences of the normalized view percentages, participants strongly favored the instrument-mounted display (IMD) even when a monitor was present (H3). This is supported by the pairwise comparisons where significant differences were clearly revealed between C1 (IMD) and C3 and, to a lesser extent, between C2 and C3, while we found no significant differences between C1 and C2
Summary
Surgical navigation systems are becoming more common throughout different disciplines, often used for operations and interventions involving very delicate structures, structures that are not perceivable without medical imagery, and for minimally invasive interventions where the natural field of view of the operator is limited. Our approach could generalize to many procedures involving an instrument large enough to carry a small display. In RF ablation and comparable procedures, a needle is inserted into the body and the tip is navigated to the target structure, such as a liver tumor, which is ablated by applying heat caused by electric current or microwaves. Our work concentrates on navigation; intervention and treatment are not considered. As the remainder of this paper will describe in
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