Evaluation of a synergistically controlled semiautomatic trepanation system for neurosurgery.

One of the most common procedures in neurosurgery is the trepanation of the skull. In this paper, a synergistically controlled handheld tool for trepanation is introduced. This instrument is envisioned to reduce problems of dural tears and wide cutting gaps by combining a soft tissue preserving saw with an automatic regulation of the cutting depth. Since usability and safety of the semi-automatic handheld device are of utmost importance, the complex interaction between the user and the system has been analyzed extensively. Based on prospective usability evaluation the user interaction design and the corresponding user-interface were developed. The compliance with the relevant factors effectiveness, efficiency, error tolerance, learnability and user satisfaction was measured in user-centered experiments to evaluate the usability of the semiautomatic trepanation system. The results confirm the user interaction design of the semiautomatic trepanation system and the corresponding safety strategy. The system seems to integrate itself smoothly into the existing workflow and keeps the surgeon aware of the process.