Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London (UCL), Charles Bell House, 43-45 Foley Street, London W1W 7TS, UK.
Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London (UCL), Charles Bell House, 43-45 Foley Street, London W1W 7TS, UK.
Med Image Anal. 2022 Apr;77:102361. doi: 10.1016/j.media.2022.102361. Epub 2022 Jan 12.
This article presents a systematic review of optical see-through head mounted display (OST-HMD) usage in augmented reality (AR) surgery applications from 2013 to 2020. Articles were categorised by: OST-HMD device, surgical speciality, surgical application context, visualisation content, experimental design and evaluation, accuracy and human factors of human-computer interaction. 91 articles fulfilled all inclusion criteria. Some clear trends emerge. The Microsoft HoloLens increasingly dominates the field, with orthopaedic surgery being the most popular application (28.6%). By far the most common surgical context is surgical guidance (n=58) and segmented preoperative models dominate visualisation (n=40). Experiments mainly involve phantoms (n=43) or system setup (n=21), with patient case studies ranking third (n=19), reflecting the comparative infancy of the field. Experiments cover issues from registration to perception with very different accuracy results. Human factors emerge as significant to OST-HMD utility. Some factors are addressed by the systems proposed, such as attention shift away from the surgical site and mental mapping of 2D images to 3D patient anatomy. Other persistent human factors remain or are caused by OST-HMD solutions, including ease of use, comfort and spatial perception issues. The significant upward trend in published articles is clear, but such devices are not yet established in the operating room and clinical studies showing benefit are lacking. A focused effort addressing technical registration and perceptual factors in the lab coupled with design that incorporates human factors considerations to solve clear clinical problems should ensure that the significant current research efforts will succeed.
本文对 2013 年至 2020 年间光学穿透式头戴式显示器（OST-HMD）在增强现实（AR）手术应用中的使用进行了系统回顾。文章根据以下标准进行分类：OST-HMD 设备、手术专业、手术应用背景、可视化内容、实验设计与评估、人机交互的准确性和人为因素。符合所有纳入标准的文章有 91 篇。一些明显的趋势出现了。微软的 HoloLens 越来越占据主导地位，骨科手术是最受欢迎的应用（28.6%）。到目前为止，最常见的手术环境是手术指导（n=58），分割的术前模型占主导地位（n=40）。实验主要涉及模拟物（n=43）或系统设置（n=21），患者病例研究排名第三（n=19），反映了该领域相对不成熟的现状。实验涵盖了从配准到感知的问题，准确性结果差异很大。人为因素对 OST-HMD 的实用性非常重要。一些因素被提出的系统所解决，例如注意力从手术部位转移，以及将 2D 图像映射到 3D 患者解剖结构的心理映射。其他持续存在的人为因素仍然存在，或者是由 OST-HMD 解决方案引起的，包括易用性、舒适性和空间感知问题。发表的文章数量明显呈上升趋势，但此类设备尚未在手术室中得到应用，缺乏显示益处的临床研究。在实验室中集中精力解决技术配准和感知因素，并结合考虑人为因素的设计来解决明显的临床问题，应该可以确保目前大量的研究工作取得成功。
