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通过混合现实技术进行腿部筋膜切开术的远程指导:STAR平台的临床评估

Telementoring in Leg Fasciotomies via Mixed-Reality: Clinical Evaluation of the STAR Platform.

作者信息

Rojas-Muñoz Edgar, Cabrera Maria Eugenia, Lin Chengyuan, Sánchez-Tamayo Natalia, Andersen Dan, Popescu Voicu, Anderson Kathryn, Zarzaur Ben, Mullis Brian, Wachs Juan P

机构信息

School of Industrial Engineering, Purdue University, 315 N. Grant St., West Lafayette, IN 47907.

Paul G. Allen School of Computer Science and Engineering, University of Washington, 185 East Stevens Way NE, Seattle, WA 98195.

出版信息

Mil Med. 2020 Jan 7;185(Suppl 1):513-520. doi: 10.1093/milmed/usz234.

Abstract

INTRODUCTION

Point-of-injury (POI) care requires immediate specialized assistance but delays and expertise lapses can lead to complications. In such scenarios, telementoring can benefit health practitioners by transmitting guidance from remote specialists. However, current telementoring systems are not appropriate for POI care. This article clinically evaluates our System for Telementoring with Augmented Reality (STAR), a novel telementoring system based on an augmented reality head-mounted display. The system is portable, self-contained, and displays virtual surgical guidance onto the operating field. These capabilities can facilitate telementoring in POI scenarios while mitigating limitations of conventional telementoring systems.

METHODS

Twenty participants performed leg fasciotomies on cadaveric specimens under either one of two experimental conditions: telementoring using STAR; or without telementoring but reviewing the procedure beforehand. An expert surgeon evaluated the participants' performance in terms of completion time, number of errors, and procedure-related scores. Additional metrics included a self-reported confidence score and postexperiment questionnaires.

RESULTS

STAR effectively delivered surgical guidance to nonspecialist health practitioners: participants using STAR performed fewer errors and obtained higher procedure-related scores.

CONCLUSIONS

This work validates STAR as a viable surgical telementoring platform, which could be further explored to aid in scenarios where life-saving care must be delivered in a prehospital setting.

摘要

引言

受伤现场(POI)护理需要立即获得专业协助,但延迟和专业知识的缺失可能会导致并发症。在这种情况下,远程指导可以通过远程专家传输指导意见使医疗从业者受益。然而,目前的远程指导系统并不适用于受伤现场护理。本文对我们的增强现实远程指导系统(STAR)进行了临床评估,这是一种基于增强现实头戴式显示器的新型远程指导系统。该系统便于携带、自成一体,并能在手术区域显示虚拟手术指导。这些功能可以在受伤现场场景中促进远程指导,同时减轻传统远程指导系统的局限性。

方法

20名参与者在两种实验条件之一的情况下,对尸体标本进行腿部筋膜切开术:使用STAR进行远程指导;或不进行远程指导,但事先查看手术过程。一名专家外科医生根据完成时间、错误数量和与手术相关的评分来评估参与者的表现。其他指标包括自我报告的信心评分和实验后问卷。

结果

STAR有效地向非专业医疗从业者提供了手术指导:使用STAR的参与者错误较少,获得的与手术相关的评分较高。

结论

这项工作验证了STAR作为一个可行的手术远程指导平台的有效性,该平台可进一步探索,以帮助在院前环境中提供救命护理的场景。

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