Surgical Planning Laboratory - Brigham & Women's Hospital - Boston, Massachusetts USA - a teaching affiliate of Harvard Medical School

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Instrument-mounted Displays for Reducing Cognitive Load during Surgical Navigation

Institution:
1Creative Unit: Intra-operative Information, University of Bremen, Bremen, Germany. herrlich@eit.uni-kl.de.
2Digital Media Lab, TZI, University of Bremen, Bremen, Germany.
3Fraunhofer MEVIS, Bremen, Germany.
4Surgical Planning Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA.
Publisher:
Springer
Publication Date:
Sep-2017
Journal:
Int J Comput Assist Radiol Surg
Volume Number:
12
Issue Number:
9
Pages:
1599-1605
Citation:
Int J Comput Assist Radiol Surg. 2017 Sep; 12(9): 1599-1605.
PubMed ID:
28233166
PMCID:
PMC5568989
Keywords:
Cognitive load, Image-guided surgery, Intra-operative navigation, Tool-mounted display, Visual attention, Visual feedback
Appears in Collections:
NAC, NCIGT, SPL
Sponsors:
P41 EB015902/EB/NIBIB NIH HHS/United States
P41 EB015898/EB/NIBIB NIH HHS/United States
Generated Citation:
Herrlich M., Tavakol P., Black D., Wenig D., Rieder C., Malaka R., Kikinis R. Instrument-mounted Displays for Reducing Cognitive Load during Surgical Navigation. Int J Comput Assist Radiol Surg. 2017 Sep; 12(9): 1599-1605. PMID: 28233166. PMCID: PMC5568989.
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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.