Mechatronics in Medicine Laboratory, Imperial College London, London, UK.
Mechatronics in Medicine Laboratory, Imperial College London, London, UK.
J Biomed Inform. 2021 Aug;120:103841. doi: 10.1016/j.jbi.2021.103841. Epub 2021 Jun 17.
BACKGROUND: The research and development of augmented-reality (AR) technologies in surgical applications has seen an evolution of the traditional user-interfaces (UI) utilised by clinicians when conducting robot-assisted orthopaedic surgeries. The typical UI for such systems relies on surgeons managing 3D medical imaging data in the 2D space of a touchscreen monitor, located away from the operating site. Conversely, AR can provide a composite view overlaying the real surgical scene with co-located virtual holographic representations of medical data, leading to a more immersive and intuitive operator experience. MATERIALS AND METHODS: This work explores the integration of AR within an orthopaedic setting by capturing and replicating the UI of an existing surgical robot within an AR head-mounted display worn by the clinician. The resulting mixed-reality workflow enabled users to simultaneously view the operating-site and real-time holographic operating informatics when carrying out a robot-assisted patellofemoral-arthroplasty (PFA). Ten surgeons were recruited to test the impact of the AR system on procedure completion time and operating surface roughness. RESULTS AND DISCUSSION: The integration of AR did not appear to require subjects to significantly alter their surgical techniques, which was demonstrated by non-significant changes to the study's clinical metrics, with a statistically insignificant mean increase in operating time (+0.778 s, p = 0.488) and a statistically insignificant change in mean surface roughness (p = 0.274). Additionally, a post-operative survey indicated a positive consensus on the usability of the AR system without incurring noticeable physical distress such as eyestrain or fatigue. CONCLUSIONS: Overall, these study results demonstrated a successful integration of AR technologies within the framework of an existing robot-assisted surgical platform with no significant negative effects in two quantitative metrics of surgical performance, and a positive outcome relating to user-centric and ergonomic evaluation criteria.
背景：增强现实（AR）技术在手术应用中的研究和开发已经改变了临床医生在进行机器人辅助骨科手术时使用的传统用户界面（UI）。此类系统的典型 UI 依赖于外科医生在远离手术现场的触摸屏监视器的 2D 空间中管理 3D 医学成像数据。相反，AR 可以提供一种复合视图，将真实手术场景与医疗数据的同地虚拟全息表示叠加在一起，从而为操作人员提供更具沉浸感和直观性的体验。
材料和方法：这项工作通过在临床医生佩戴的 AR 头戴式显示器中捕获和复制现有手术机器人的 UI，探索了在骨科环境中集成 AR。由此产生的混合现实工作流程使用户能够在进行机器人辅助髌股关节成形术（PFA）时同时查看手术现场和实时全息手术信息。招募了 10 名外科医生来测试 AR 系统对手术完成时间和手术表面粗糙度的影响。
结果与讨论：AR 的集成似乎不需要研究对象显著改变他们的手术技术，这一点通过研究的临床指标没有显著变化得到证明，手术时间的统计学上无显著增加（平均增加 0.778 秒，p=0.488），手术表面粗糙度的统计学上无显著变化（p=0.274）。此外，术后调查表明，AR 系统的可用性得到了积极的共识，没有引起明显的身体不适，如眼疲劳或疲劳。
结论：总的来说，这些研究结果表明，在现有的机器人辅助手术平台框架内成功地集成了 AR 技术，在两个手术性能的定量指标中没有显著的负面影响，并且在用户为中心和人体工程学评估标准方面有积极的结果。
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