Operational View Research Articles

Immersive reality for robotic surgical training: a pilot study using 3D visors for immersive view of the operating field.

Immersive intracorporeal vision is a key feature of robotic surgery, limited today to only one trainee per operation when the dual console is available. We developed a tool that provides a virtually unlimited number of surgeons with the operator's view, with the possibility to also watch the surgeon's hand movements and the operating table. In this study, we aim to assess trainees' reaction to this innovative training method. Medical students and surgery residents were offered an immersive experience with head-mounted devices, showing a didactic video in a 360° virtual space with 3D intracorporeal robotic vision, the surgeon's hand movements and the surrounding operating room during a robotic rectal resection with total mesorectal excision. Subsequently, participants were asked to fill a questionnaire evaluating the user's reaction to the new training tool including the validated System Usability Scale (SUS) and Simulator Sickness Questionnaire (SSQ), and non-validated questions. 102 participants took part in the training and the assessment questionnaires, 94 (92%) medical students and 8 (8%) surgery residents. Users' feedback was overall positive. In the engagement and intention to use items, almost 90% of the respondents voted for a complete or near complete agreement. The median SUS score was 80 [IQR 70-90]. The median SSQ score was 44.88 [IQR 22.44-82.28]. Exposing trainees to immersive robotic vision of the surgical field had a positive reaction from our audience. Our initial results encourage further implementing this technology in surgical training of medical students and residents to prove its efficacy.

An operator view on trends in core acquisition

Abstract Core samples from the subsurface can provide unambiguous direct information to guide operator decisions. Core may be acquired with drilling equipment (full-bore core) or by post-drill wireline methods (sidewall core). Both approaches have distinct profiles of cost, risk, sample type and value, and an operator must select the most appropriate to progress business in an informed way. The option to selectively core after drilling and perceptions of lower cost and risk might indicate that sidewall coring will always be the best approach. Recent developments to increase the size and quality of rotary sidewall samples would only add weight to this view. It is not all good news for sidewall core, however. Individual sample size and total volume delivered per run are tiny; weak rock or high overbalance pressure may cause poor recovery and biased datasets; time between drilling and logging allows mud invasion and borehole relaxation, so samples are often broken and pore fluids contaminated. Sidewall sample sets therefore leave a higher degree of uncertainty when compared to full-bore core. It is this operator's view that both approaches have a role to play in reducing subsurface uncertainty, and cost, risk and value should be carefully considered when deciding which to apply.

Development of an Intraoperative Pipeline for Holographic Mixed Reality Visualization During Spinal Fusion Surgery.

Objective. Holographic mixed reality (HMR) allows for the superimposition of computer-generated virtual objects onto the operator's view of the world. Innovative solutions can be developed to enable the use of this technology during surgery. The authors developed and iteratively optimized a pipeline to construct, visualize, and register intraoperative holographic models of patient landmarks during spinal fusion surgery. Methods. The study was carried out in two phases. In phase 1, the custom intraoperative pipeline to generate patient-specific holographic models was developed over 7 patients. In phase 2, registration accuracy was optimized iteratively for 6 patients in a real-time operative setting. Results. In phase 1, an intraoperative pipeline was successfully employed to generate and deploy patient-specific holographic models. In phase 2, the registration error with the native hand-gesture registration was 20.2 ± 10.8mm (n = 7 test points). Custom controller-based registration significantly reduced the mean registration error to 4.18 ± 2.83mm (n = 24 test points, P < .01). Accuracy improved over time (B = -.69, P < .0001) with the final patient achieving a registration error of 2.30 ± .58mm. Across both phases, the average model generation time was 18.0 ± 6.1minutes (n = 6) for isolated spinal hardware and 33.8 ± 8.6minutes (n = 6) for spinal anatomy. Conclusions. A custom pipeline is described for the generation of intraoperative 3D holographic models during spine surgery. Registration accuracy dramatically improved with iterative optimization of the pipeline and technique. While significant improvements and advancements need to be made to enable clinical utility, HMR demonstrates significant potential as the next frontier of intraoperative visualization.

Theory of Relativity for Posterosuperior Segments of the Liver.

The accessibility to posterosuperior segments of the liver has traditionally constituted a restrain to adopt the laparoscopic approach in this setting. To overcome this challenge, multiple approaches have been reported in literature. Total transabdominal approach has been previously described for this purpose, even though the rationale to standardly adopt it and a technical depiction of how to achieve an optimal mobilization has never been specifically addressed. Total transabdominal purely laparoscopic approach to posterosuperior segments of the liver is presented, with detailed emphasis to the rotational motions targeted in laparoscopy. A literature review is presented to summarize all other possible accesses to posterosuperior area of the liver. The institutional series for the laparoscopic approach to Sg 7, Sg 6+7, and Sg8 is retrospectively described. Three rotational motions of the liver are specifically addressed in a video presentation and described for the laparoscopic total-transabdominal approach; the local institutional series using this approach is presented. Other miscellaneous approaches identified from literature encompassing variations in operative position, transabdominal, transthoracic, and combined approaches are described. Complete mobilization of the ligaments of the liver leads to a rotation of the transection line in front of the operator's view, allowing to achieve a safe total trans-abdominal laparoscopic approach to the posterosuperior ligaments of the liver, without compromising the vascular inflow control, the possibility to convert to open approach, nor requiring potentially harmful decubitus.

D7-3 From the Point of a Tower Crane Operator's View: Use of an Eye-Tracker in Construction Sites

The need for high-rise building constructions, large-scale apartment blocks, or construction in urban areas raised the number of tower crane use. For safe and efficient activities in construction sites; tower crane type selection, decision of tower crane location, decision of load type, load location, specified area, and their supply, securing equipment, also the work schedules and maintenance should carefully be planned. This study proposes a methodology to support accident management in construction sites where a single tower crane is used. Aim is to identify the risks during operations and rank the severity levels of the activities to avoid property damage and bodily injuries. Up to best knowledge, a mobile type eye-tracker is used for the first time to record the view of tower crane operator during operations. In the first step, operator is asked to wear the eye-tracker as a regular glasses and climb the operating cabin that is attached to the structure of the tower crane. Based on the video records, it is possible assess not only the guiderails, handholds, steps, and trap door but also the operating cabin interior design in terms of control unit locations, window panels. In the second step, the data collected during material handling operations is used to assess the location of loads, potential risks for the slinger who is responsible for attaching and detaching the load to and from the crane and the signaler who is responsible for relaying the signal from the slinger to the crane operator and directing the safe movement of the crane. The visual attention of the tower crane operator and working postures are evaluated. In the third step, the records when tower crane operator is descending the ladder of the tower are considered. Obtained data is interpreted as indicators of fatigue such as duration of fixation, number of fixation, and pupil size change. Data obtained from two construction sites (one constructed near the single building construction site and other between two buildings construction site) where one tower crane is used to test the hypothesis. Results illustrate that the location of tower crane have a significant effect on safe operations for the crane operator. Further comments are made based on the possible impacts of communication system, high visibility clothing, and weather conditions for an efficient accident management.

Research on Superimposed Terrain Model for Teleoperation Work Efficiency

[abstFig src='/00280002/08.jpg' width=""300"" text='Superimposed terrain model in operator's view image' ]In recent years, unmanned construction based on the teleoperation of construction equipment has increasingly been used in disaster sites or mines. However, operations based on teleoperation are based on 2D images, in which the lack of perspective results in considerably lower efficiency when compared with on-board operations. Previous studies employed multi-viewpoint images or binocular stereo, which resulted in problems, such as lower efficiency, caused by the operator's need to evaluate distances by shifting his or her line of sight, or eye fatigue due to binocular stereo. Thus, the present study aims to improve the work efficiency of teleoperation by superimposing a 3D model of the terrain on the on-board operator's view image. The surrounding terrain is measured by a depth image sensor and represented as a digital terrain model, which is generated and updated in real time. The terrain model is transformed into the on-board operator's view, on which an artificial shadow of the bucket tip and an evenly spaced grid projected to the ground surface are superimposed. This allows the operator to visually evaluate the bucket tip position from the artificial shadow and the distance between the excavation point and bucket tip from the terrain grid. An experiment was conducted investigating the positioning of the bucket tip by teleoperation using a miniature excavator and the terrain model superimposed display. The results showed that the standard deviations of the positioning errors measured with the superimposed display were lower by 30% or more than those obtained without the superimposed display, while they were approximately equal to those acquired using binocular stereo. We thus demonstrated the effectiveness of the superimposed display in improving work efficiency in teleoperation.

3P1-B03 中心静脈穿刺支援マニピュレータの開発(医療ロボティクス・メカトロニクス(2))

We are developing a robotic needle insertion system for assist of central venous catheterization that relieves the difficulties of manual procedure and reduce the complications. In this paper, we propose a new design prototype manipulator which weight is reduced and which is integrated with a display of ultrasonography to progress in the operability of our robotic needle insertion system. The new version manipulator weighs lighter than 500[g] using a worm gear mechanism in exchange of a RCM mechanism, and the new version manipulator has a display of ultrasonography placed in the field of operator's view during manipulation of this system. Additionally, it was suggested that the new version manipulator kept the same positioning precision as the old version of manipulator by an evaluation experiment.

Executable Architecture based on System Dynamics: An Integrated Methodology Composed by Standard System Dynamics Modelling and DoDAF Operational View Models.

Executable Architectures (EA) have proven to be useful in enabling more integrated and holistic way to assessment and architectures, due these allow validation logic, behavior and performance of dynamical systems that are modeled statically formal languages such as Unified Modeling Language, Systems Modeling Language and Business Process Modeling Notation, complemented by the simulation, so that they can be visualized and analyzed with respect to time.This article briefly discusses the main methodologies of Modeling Dynamic Systems designed by Andrew Ford and Sterman, highlighting how some of the models of the Operational View (OV) of DoDAF provide key elements in building an EA based on systems dynamic. It shows how the incorporation of standard methodologies, integrated models of DoDAF OV allow us to create AE more efficiently.

A Randomized Trial Comparing the Diagnostic Yield of Rigid and Semirigid Thoracoscopy in Undiagnosed Pleural Effusions

Thoracoscopic pleural biopsy increases the diagnostic yield of pleural effusions undiagnosed after thoracentesis and is superior to closed pleural biopsy. Medical thoracoscopy can be performed using the rigid thoracoscope or the semirigid thoracoscope (pleuroscope). In this randomized trial, we compare the efficacy and safety of the 2 thoracoscopes. Subjects with undiagnosed exudative pleural effusions were randomly assigned to undergo pleural biopsy with either the rigid or the semirigid thoracoscope. The primary outcome was the diagnostic yield of the procedure, while the secondary outcomes were requirement of sedative/analgesic agents, scar size, biopsy sample size, and the operator's view of the procedure. Of the 145 screened subjects with exudative pleural effusions, 90 were randomized to undergo thoracoscopy with the 2 thoracoscopes (n = 45 each). The diagnostic yield of rigid thoracoscopy was superior to semirigid thoracoscopy (97.8% vs 73.3%, P = .002) on an intention-to-treat analysis but was similar (100% vs 94.3%, P = .18) in those with successful biopsy. The requirement of sedative/analgesic agents was higher in the rigid thoracoscopy arm. The scar size was slightly larger (mean ± SD, 23.1 ± 4 vs 18.7 ± 3.2 mm, P = .0001), whereas the biopsy sample size was distinctly larger in the rigid arm (mean ± SD, 13.9 ± 4.4 vs 4.4 ± 1.4 mm, P = .001). The operator-rated visual analog scale score for the ease of taking a biopsy sample was significantly higher with the rigid instrument (mean ± SD, visual analog scale 86 ± 12 vs 79 ± 12 mm, P = .01), while the quality of image was superior in the semirigid arm (mean ± SD, visual analog scale 88 ± 7 vs 92 ± 5 mm, P = .002). The number of complications were similar in the 2 groups. Rigid thoracoscopy was found to be superior to semirigid thoracoscopy overall, but the diagnostic yield was similar if pleural biopsy could be successfully performed. Due to the small sample size, a larger study is required to define the usefulness and choice between the 2 procedures. (ClinicalTrials.gov registration NCT01726556).

The Worringham and Beringer ‘visual field’ principle for rotary controls

Worringham and Beringer (1989, 1998) developed a very important principle relating compatibility of movement of horizontally moving translational controls to display movements when the operator's view of the display is in a plane different to that of the control. On the basis of past data of the current authors, it is shown that the visual field principle also applies to the operation of vertically moving translational controls and to rotary controls. These additions make the Worringham and Beringer principle the most powerful design principle available for situations where the operator is viewing a display that is not in the same plane as the control.

Routing Scalability: An Operator's View

The Internet and its associated global routing table continues to grow with time. Will the current routing infrastructure be able to scale itself to sustain such growth? Over the past several years, many efforts have been devoted to address this important question. This paper presents a unique view from a network operator's perspective. We first clarify the definition of the routing scaling problem in practical terms by providing the relevant background information. We point out several reality issues that, if overlooked, may impede the adoption and deployment of a solution. Based on our operational experiences, we identify several requirements for potential solutions, and provide brief comments on the existing solutions.

The operator's view of OTN evolution

This article presents OTN evolution from an operator's point of view, including the history of the transport network, the role of the OTN, and the motivations and requirements for OTN evolution. First, a history of transport networks and the role of the OTN in today's networks is reviewed. Next, the motivation for the OTN evolution, operator requirements, and new OTN capabilities are described. Lastly, the future of the OTN is discussed.

High-viscosity polymethylmethacrylate cement for endoscopic anterior cranial base reconstruction

Endoscopic endonasal transsphenoidal surgery (ETSS) is an effective, minimally invasive approach for the resection of anterior skull base tumors. Cerebrospinal leakage is a common complication, and repair of the anterior skull base defect with alloplastic materials has been used to minimize the risk of postoperative CSF rhinorrhea and meningitis. Injectable cements, such as low-viscosity polymethylmethacrylate (PMMA), are useful for cranial base reconstruction because they are easy to shape to the contour of the defect. These low-viscosity materials, however, are more susceptible to leakage into the nasal cavity prohibiting their use and are prone to cracking upon hardening. Cement extravasation not only obstructs the operator's view during placement, but it is also associated with significant local and systemic complications. High-viscosity (HV) PMMA-based cement and its specialized delivery system have recently been shown to be safe and effective in human applications. Moreover, its constant high viscosity significantly reduces cement leakage and its associated complications. The authors hypothesized that this type of cement would therefore be ideal for ETSS to repair anterior skull base defects. The authors report their experience using HV-PMMA to reconstruct the anterior skull base in 12 patients following ETSS. The unique puttylike consistency of this material is easy to work, malleable, does not leak into the nasal cavity, does not aspirate into suction tubing, and hardens without cracks in less than 10 minutes. None of the 12 patients suffered postoperative CSF leaks or infections more than 8 months, on average, after surgery. Although not necessary in all cases of ETSS, the authors conclude that HV-PMMA, if needed, may be an excellent choice for reconstructing the anterior skull base after ETSS. Further studies are needed to better assess the long-term outcomes of HV-PMMA cement and its use in repairing skull base defects after extended ETSS.

Wide area ubiquitous network: the network operator's view of a sensor network

This article describes a network concept called the area ubiquitous network (WAUN) and its research activities. WAUN is a network for sensors and actuators, and can support low-end wireless which are expected to be used for new applications. Among the many types of R&D being performed in the WAUN project, this article focuses on the feasibility of its basic feature and target. The basic feature is wide coverage using very-low-power-consumption terminals, and its specific target is a 5-km cell radius using 10-mW transmission power terminals with a battery life of 10 years. The results of a basic field experiment and a laboratory experiment suggest that the target seems to be feasible using wireless technologies such as diversity reception (with additional future effort to improve the packet error rate for use in business districts) and LSI technologies such as a power switch fabricated in a CMOS/SOI LSI.

An Operator Overview of the Fiber Infrastructure Evolution

In this article, the authors present an operator's view on the evolution towards optical fiber telecommunication networks. First we describe the evolution of standards related to optical fiber. Then we propose a description of hot topics concerning fiber infrastructure over three areas of the telecommunication networks (transport, access, and home). Finally we highlight the key challenges related to fiber-based optical communication networks.

Extending DoDAF to Allow Integrated DEVS-Based Modeling and Simulation

A recent DoD mandate requires that the DoD Architecture Framework (DoDAF) be adopted to express high-level system and operational requirements and architectures. DoDAF is the basis for integrated architectures and provides broad levels of specification related to operational, system, and technical views. The combination of DoDAF operational views, which capture the requirements of the architecture, and systems views, which provide its technical attributes, forms the basis for semi-automated construction of the needed simulation models. Unfortunately, DoDAF doesn't mandate any simulation methodology to analyze the system or perform any pre-design feasibility studies. In this paper, we describe an approach to support specification of DoDAF architectures within a development environment based on DEVS (Discrete Event System Specification). The result is an enhanced system life cycle development process that includes both development and testing in an integral manner. We introduce two new operational views (OVs) in the current DoDAF making way for modeling and simulation as a part of the design process. We illustrate the process to build these new OVs from the existing OVs and their impact on the overall DoDAF system development process. We discuss automated model generation using XML through the introduced OVs, which paves the way for OVs to become service-providing components in the web services architecture.

Economics of fixed broadband access network strategies

This article presents a comprehensive techno-economic evaluation of two upgrade strategy cases for broadband IP services for residential and business customers, and illustrates their respective merits and pitfalls, allowing the definition of a reasonable investment policy. The work should enable establishment of guidelines for broadband infrastructure upgrade strategies from the incumbent operator's view. Following the definition of appropriate service sets, and taking into account demand scenarios established within the project, this work has been focused on developing a techno-economic model, based on the TONIC tool. Tariff structures have been applied to compute the key economic indicators, net present value, internal rate of return, and payback period. This investment analysis was carried using the tool, which was developed by IST-TONIC. The results show that the choice of technology (Ethernet or ATM) has almost no effect on the cost level and profitability of the cases. For the suburban area, a fiber to the cabinet solution is too expensive due to heavy infrastructure investments; for dense urban and urban areas the FTTC solution is worth the investments. The FTTH/office deployment scenario is only profitable in dense urban areas (>5000 potential customers/km <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sup> ) and already highly risky in the urban area.

The intelligent alarm management system

Nuisance alarms often clutter and obscure a process plant operator's view of critical information, with potentially severe consequences. The intelligent alarm management system (IAMS) suppresses nuisance alarms and provides valuable advisory information to help the operator focus quickly on important alarm information and take correct, quick actions. Test results show that IAMS effectively suppresses nuisance alarms, making alarm systems more helpful.

Intelligent Alarm Management Through Suppressing Nuisance Alarms and Providing Operator Advice

Nuisance alarms often clutter and obscure an operator's view of critical and important information. In this paper, an intelligent alarm management system for a refinery plant is presented. Its function includes nuisance alarm suppression, intelligent advisory information to guide operator response, and result recovery mechanism in case of system failure. This system is implemented on Distributed Control System (DCS) and validated in real online tests. The results show that nuisance alarms are effectively suppressed and the DCS alarm system becomes more helpful.

An operator's view of hot isostatic pressing : E.J.Tenerini. (Bodycote IMT, Inc, USA.)

An operator's view of hot isostatic pressing : E.J.Tenerini. (Bodycote IMT, Inc, USA.)