Surgical Telementoring Without Encumbrance

A Comparative Study of See-through Augmented Reality-based Approaches

Edgar Rojas-Muñoz, Maria Eugenia Cabrera, Daniel Andersen, Voicu Popescu, Sherri Marley, Brian Mullis, Ben Zarzaur, Juan Wachs

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

OBJECTIVE: This study investigates the benefits of a surgical telementoring system based on an augmented reality head-mounted display (ARHMD) that overlays surgical instructions directly onto the surgeon's view of the operating field, without workspace obstruction. SUMMARY BACKGROUND DATA: In conventional telestrator-based telementoring, the surgeon views annotations of the surgical field by shifting focus to a nearby monitor, which substantially increases cognitive load. As an alternative, tablets have been used between the surgeon and the patient to display instructions; however, tablets impose additional obstructions of surgeon's motions. METHODS: Twenty medical students performed anatomical marking (Task1) and abdominal incision (Task2) on a patient simulator, in 1 of 2 telementoring conditions: ARHMD and telestrator. The dependent variables were placement error, number of focus shifts, and completion time. Furthermore, workspace efficiency was quantified as the number and duration of potential surgeon-tablet collisions avoided by the ARHMD. RESULTS: The ARHMD condition yielded smaller placement errors (Task1: 45%, P < 0.001; Task2: 14%, P = 0.01), fewer focus shifts (Task1: 93%, P < 0.001; Task2: 88%, P = 0.0039), and longer completion times (Task1: 31%, P < 0.001; Task2: 24%, P = 0.013). Furthermore, the ARHMD avoided potential tablet collisions (4.8 for 3.2 seconds in Task1; 3.8 for 1.3 seconds in Task2). CONCLUSION: The ARHMD system promises to improve accuracy and to eliminate focus shifts in surgical telementoring. Because ARHMD participants were able to refine their execution of instructions, task completion time increased. Unlike a tablet system, the ARHMD does not require modifying natural motions to avoid collisions.

Original languageEnglish (US)
Pages (from-to)384-389
Number of pages6
JournalAnnals of surgery
Volume270
Issue number2
DOIs
StatePublished - Aug 1 2019

Fingerprint

Head
Tablets
Medical Students
Surgeons

ASJC Scopus subject areas

  • Surgery

Cite this

Surgical Telementoring Without Encumbrance : A Comparative Study of See-through Augmented Reality-based Approaches. / Rojas-Muñoz, Edgar; Cabrera, Maria Eugenia; Andersen, Daniel; Popescu, Voicu; Marley, Sherri; Mullis, Brian; Zarzaur, Ben; Wachs, Juan.

In: Annals of surgery, Vol. 270, No. 2, 01.08.2019, p. 384-389.

Research output: Contribution to journalArticle

Rojas-Muñoz, E, Cabrera, ME, Andersen, D, Popescu, V, Marley, S, Mullis, B, Zarzaur, B & Wachs, J 2019, 'Surgical Telementoring Without Encumbrance: A Comparative Study of See-through Augmented Reality-based Approaches', Annals of surgery, vol. 270, no. 2, pp. 384-389. https://doi.org/10.1097/SLA.0000000000002764
Rojas-Muñoz, Edgar ; Cabrera, Maria Eugenia ; Andersen, Daniel ; Popescu, Voicu ; Marley, Sherri ; Mullis, Brian ; Zarzaur, Ben ; Wachs, Juan. / Surgical Telementoring Without Encumbrance : A Comparative Study of See-through Augmented Reality-based Approaches. In: Annals of surgery. 2019 ; Vol. 270, No. 2. pp. 384-389.
@article{054a23f391df4d80ac515d9a945036f2,
title = "Surgical Telementoring Without Encumbrance: A Comparative Study of See-through Augmented Reality-based Approaches",
abstract = "OBJECTIVE: This study investigates the benefits of a surgical telementoring system based on an augmented reality head-mounted display (ARHMD) that overlays surgical instructions directly onto the surgeon's view of the operating field, without workspace obstruction. SUMMARY BACKGROUND DATA: In conventional telestrator-based telementoring, the surgeon views annotations of the surgical field by shifting focus to a nearby monitor, which substantially increases cognitive load. As an alternative, tablets have been used between the surgeon and the patient to display instructions; however, tablets impose additional obstructions of surgeon's motions. METHODS: Twenty medical students performed anatomical marking (Task1) and abdominal incision (Task2) on a patient simulator, in 1 of 2 telementoring conditions: ARHMD and telestrator. The dependent variables were placement error, number of focus shifts, and completion time. Furthermore, workspace efficiency was quantified as the number and duration of potential surgeon-tablet collisions avoided by the ARHMD. RESULTS: The ARHMD condition yielded smaller placement errors (Task1: 45{\%}, P < 0.001; Task2: 14{\%}, P = 0.01), fewer focus shifts (Task1: 93{\%}, P < 0.001; Task2: 88{\%}, P = 0.0039), and longer completion times (Task1: 31{\%}, P < 0.001; Task2: 24{\%}, P = 0.013). Furthermore, the ARHMD avoided potential tablet collisions (4.8 for 3.2 seconds in Task1; 3.8 for 1.3 seconds in Task2). CONCLUSION: The ARHMD system promises to improve accuracy and to eliminate focus shifts in surgical telementoring. Because ARHMD participants were able to refine their execution of instructions, task completion time increased. Unlike a tablet system, the ARHMD does not require modifying natural motions to avoid collisions.",
author = "Edgar Rojas-Mu{\~n}oz and Cabrera, {Maria Eugenia} and Daniel Andersen and Voicu Popescu and Sherri Marley and Brian Mullis and Ben Zarzaur and Juan Wachs",
year = "2019",
month = "8",
day = "1",
doi = "10.1097/SLA.0000000000002764",
language = "English (US)",
volume = "270",
pages = "384--389",
journal = "Annals of Surgery",
issn = "0003-4932",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Surgical Telementoring Without Encumbrance

T2 - A Comparative Study of See-through Augmented Reality-based Approaches

AU - Rojas-Muñoz, Edgar

AU - Cabrera, Maria Eugenia

AU - Andersen, Daniel

AU - Popescu, Voicu

AU - Marley, Sherri

AU - Mullis, Brian

AU - Zarzaur, Ben

AU - Wachs, Juan

PY - 2019/8/1

Y1 - 2019/8/1

N2 - OBJECTIVE: This study investigates the benefits of a surgical telementoring system based on an augmented reality head-mounted display (ARHMD) that overlays surgical instructions directly onto the surgeon's view of the operating field, without workspace obstruction. SUMMARY BACKGROUND DATA: In conventional telestrator-based telementoring, the surgeon views annotations of the surgical field by shifting focus to a nearby monitor, which substantially increases cognitive load. As an alternative, tablets have been used between the surgeon and the patient to display instructions; however, tablets impose additional obstructions of surgeon's motions. METHODS: Twenty medical students performed anatomical marking (Task1) and abdominal incision (Task2) on a patient simulator, in 1 of 2 telementoring conditions: ARHMD and telestrator. The dependent variables were placement error, number of focus shifts, and completion time. Furthermore, workspace efficiency was quantified as the number and duration of potential surgeon-tablet collisions avoided by the ARHMD. RESULTS: The ARHMD condition yielded smaller placement errors (Task1: 45%, P < 0.001; Task2: 14%, P = 0.01), fewer focus shifts (Task1: 93%, P < 0.001; Task2: 88%, P = 0.0039), and longer completion times (Task1: 31%, P < 0.001; Task2: 24%, P = 0.013). Furthermore, the ARHMD avoided potential tablet collisions (4.8 for 3.2 seconds in Task1; 3.8 for 1.3 seconds in Task2). CONCLUSION: The ARHMD system promises to improve accuracy and to eliminate focus shifts in surgical telementoring. Because ARHMD participants were able to refine their execution of instructions, task completion time increased. Unlike a tablet system, the ARHMD does not require modifying natural motions to avoid collisions.

AB - OBJECTIVE: This study investigates the benefits of a surgical telementoring system based on an augmented reality head-mounted display (ARHMD) that overlays surgical instructions directly onto the surgeon's view of the operating field, without workspace obstruction. SUMMARY BACKGROUND DATA: In conventional telestrator-based telementoring, the surgeon views annotations of the surgical field by shifting focus to a nearby monitor, which substantially increases cognitive load. As an alternative, tablets have been used between the surgeon and the patient to display instructions; however, tablets impose additional obstructions of surgeon's motions. METHODS: Twenty medical students performed anatomical marking (Task1) and abdominal incision (Task2) on a patient simulator, in 1 of 2 telementoring conditions: ARHMD and telestrator. The dependent variables were placement error, number of focus shifts, and completion time. Furthermore, workspace efficiency was quantified as the number and duration of potential surgeon-tablet collisions avoided by the ARHMD. RESULTS: The ARHMD condition yielded smaller placement errors (Task1: 45%, P < 0.001; Task2: 14%, P = 0.01), fewer focus shifts (Task1: 93%, P < 0.001; Task2: 88%, P = 0.0039), and longer completion times (Task1: 31%, P < 0.001; Task2: 24%, P = 0.013). Furthermore, the ARHMD avoided potential tablet collisions (4.8 for 3.2 seconds in Task1; 3.8 for 1.3 seconds in Task2). CONCLUSION: The ARHMD system promises to improve accuracy and to eliminate focus shifts in surgical telementoring. Because ARHMD participants were able to refine their execution of instructions, task completion time increased. Unlike a tablet system, the ARHMD does not require modifying natural motions to avoid collisions.

UR - http://www.scopus.com/inward/record.url?scp=85069815514&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85069815514&partnerID=8YFLogxK

U2 - 10.1097/SLA.0000000000002764

DO - 10.1097/SLA.0000000000002764

M3 - Article

VL - 270

SP - 384

EP - 389

JO - Annals of Surgery

JF - Annals of Surgery

SN - 0003-4932

IS - 2

ER -