ICT/UNIFESP, Instituto de Ciência e Tecnologia, Universidade Federal de São Paulo, Brazil; INESC-ID Lisboa, Instituto Superior Técnico, Universidade de Lisboa, Portugal.
INESC-ID Lisboa, Instituto Superior Técnico, Universidade de Lisboa, Portugal.
J Biomed Inform. 2020 Jul;107:103463. doi: 10.1016/j.jbi.2020.103463. Epub 2020 Jun 18.
One of the most promising applications of Optical See-Through Augmented Reality is minimally laparoscopic surgery, which currently suffers from problems such as surgeon discomfort and fatigue caused by looking at a display positioned outside the surgeon's visual field, made worse by the length of the procedure. This fatigue is especially felt on the surgeon's neck, as it is strained from adopting unnatural postures in order to visualise the laparoscopic video feed. Throughout this paper, we will present work in Augmented Reality, as well as developments in surgery and Augmented Reality applied to both surgery in general and laparoscopy in particular to address these issues. We applied user and task analysis methods to learn about practices performed in the operating room by observing surgeons in their working environment in order to understand, in detail, how they performed their tasks and achieved their intended goals. Drawing on observations and analysis of video recordings of laparoscopic surgeries, we identified relevant constraints and design requirements. Besides proposals to approach the ergonomic issues, we present a design and implementation of a multimodal interface to enhance the laparoscopic procedure. Our method makes it more comfortable for surgeons by allowing them to keep the laparoscopic video in their viewing area regardless of neck posture. Also, our interface makes it possible to access patient imaging data without interrupting the operation. It also makes it possible to communicate with team members through a pointing reticle. We evaluated how surgeons perceived the implemented prototype, in terms of usefulness and usability, via a think-aloud protocol to conduct qualitative evaluation sessions which we describe in detail in this paper. In addition to checking the advantages of the prototype as compared to traditional laparoscopic settings, we also conducted a System Usability Scale questionnaire for measuring its usability, and a NASA Task Load Index questionnaire to rate perceived workload and to assess the prototype effectiveness. Our results show that surgeons consider that our prototype can improve surgeon-to-surgeon communication using head pose as a means of pointing. Also, surgeons believe that our approach can afford a more comfortable posture throughout the surgery and enhance hand-eye coordination, as physicians no longer need to twist their necks to look at screens placed outside the field of operation.
光透式增强现实的最有前途的应用之一是微创腹腔镜手术，目前这种手术存在一些问题，例如外科医生在观看位于视野之外的显示屏时会感到不适和疲劳，而手术的时间越长，这种疲劳感就越明显。由于需要采用不自然的姿势来观察腹腔镜视频，外科医生的颈部会感到特别疲劳。在本文中，我们将介绍增强现实领域的工作，以及手术领域和增强现实技术的发展，这些技术应用于一般手术和腹腔镜手术，以解决这些问题。我们应用用户和任务分析方法，通过观察外科医生在工作环境中的操作，了解他们在手术室中的操作实践，详细了解他们如何完成任务和实现目标。通过对腹腔镜手术的视频记录进行观察和分析，我们确定了相关的约束条件和设计要求。除了提出解决人体工程学问题的方案外，我们还设计并实现了一种多模态接口，以增强腹腔镜手术。我们的方法使外科医生在保持颈部舒适的同时，将腹腔镜视频保留在他们的视野中，无论他们的颈部姿势如何。此外，我们的接口还可以在不中断手术的情况下访问患者的成像数据。它还可以通过一个指向十字线与手术团队成员进行交流。我们通过“出声思考”协议评估了外科医生对实施原型的看法，从有用性和可用性两个方面进行了定性评估，我们在本文中详细描述了这些评估。除了检查原型相对于传统腹腔镜设置的优势外，我们还进行了系统可用性量表问卷调查，以衡量其可用性，并进行了 NASA 任务负荷指数问卷调查，以评估感知工作量和评估原型的有效性。我们的结果表明，外科医生认为我们的原型可以通过使用头部姿势作为指向的方式来改善外科医生之间的沟通。此外，外科医生认为我们的方法可以使手术过程中的姿势更加舒适，并增强手眼协调能力，因为医生不再需要扭动脖子去看放置在手术视野之外的屏幕。
