Department of Simulation and Graphics, Faculty of Computer Science, Otto von Guericke University Magdeburg, Magdeburg, Germany.
Clinic of Urology and Paediatric Urology, University Hospital of Magdeburg, Magdeburg, Germany.
PLoS One. 2019 Jul 18;14(7):e0219920. doi: 10.1371/journal.pone.0219920. eCollection 2019.
Intraoperative software assistance is gaining increasing importance in laparoscopic and robot-assisted surgery. Within the user-centred development process of such systems, the first question to be asked is: What information does the surgeon need and when does he or she need it? In this article, we present an approach to investigate these surgeon information needs for minimally invasive partial nephrectomy and compare these needs to the relevant surgical computer assistance literature.
First, we conducted a literature-based hierarchical task analysis of the surgical procedure. This task analysis was taken as a basis for a qualitative in-depth interview study with nine experienced surgical urologists. The study employed a cognitive task analysis method to elicit surgeons' information needs during minimally invasive partial nephrectomy. Finally, a systematic literature search was conducted to review proposed software assistance solutions for minimally invasive partial nephrectomy. The review focused on what information the solutions present to the surgeon and what phase of the surgery they aim to support.
The task analysis yielded a workflow description for minimally invasive partial nephrectomy. During the subsequent interview study, we identified three challenging phases of the procedure, which may particularly benefit from software assistance. These phases are I. Hilar and vascular management, II. Tumour excision, and III. Repair of the renal defects. Between these phases, 25 individual challenges were found which define the surgeon information needs. The literature review identified 34 relevant publications, all of which aim to support the surgeon in hilar and vascular management (phase I) or tumour excision (phase II).
The work presented in this article identified unmet surgeon information needs in minimally invasive partial nephrectomy. Namely, our results suggest that future solutions should address the repair of renal defects (phase III) or put more focus on the renal collecting system as a critical anatomical structure.
术中软件辅助在腹腔镜和机器人辅助手术中变得越来越重要。在这种系统的以用户为中心的开发过程中，首先要问的问题是：外科医生需要什么信息，他或她什么时候需要？在本文中，我们提出了一种方法来调查微创部分肾切除术的外科医生信息需求，并将这些需求与相关的手术计算机辅助文献进行比较。
首先，我们对手术过程进行了基于文献的层次任务分析。该任务分析作为与九位经验丰富的外科泌尿科医生进行定性深入访谈研究的基础。该研究采用认知任务分析方法来引出外科医生在微创部分肾切除术中的信息需求。最后，进行了系统的文献检索，以回顾微创部分肾切除术的软件辅助解决方案。该综述重点关注解决方案向外科医生提供的信息以及它们旨在支持手术的哪个阶段。
任务分析产生了微创部分肾切除术的工作流程描述。在随后的访谈研究中，我们确定了该手术过程中的三个具有挑战性的阶段，这些阶段可能特别受益于软件辅助。这些阶段是 I. 肾脏门和血管管理，II. 肿瘤切除，和 III. 肾脏缺损修复。在这些阶段之间，发现了 25 个单独的挑战，这些挑战定义了外科医生的信息需求。文献综述确定了 34 篇相关出版物，它们都旨在支持外科医生进行肾脏门和血管管理（阶段 I）或肿瘤切除（阶段 II）。
本文介绍的工作确定了微创部分肾切除术中医务人员的未满足的信息需求。即，我们的结果表明，未来的解决方案应该解决肾脏缺损的修复（阶段 III），或更关注作为关键解剖结构的肾脏集合系统。
