Auditory support for resection guidance in navigated liver surgery

Abstract

Background An alternative mode of interaction with navigation systems for open liver surgery was requested. Surgeons who use such systems are impeded by having to constantly switch between viewing the navigation system screen and the patient during an operation. Methods To this end, an auditory display system for open liver surgery is introduced with support for guiding the tracked instrument towards and remaining on a predefined resection line. In order to evaluate the method, a clinically orientated user study with 12 surgeons was conducted.Results Qualitative results from the user study show that the proposed auditory display is recognized as a useful addition to the current visual mode of interaction. A statistical analysis revealed that participants spent less time looking on the screen (10 % versus 96 %). Accuracy for resection guidance was significantly improved when using auditory display as an additional information channel (0.6 mm versus 1.4 mm), however, the overall time for the resection task was shorter without auditory display (47 sec versus 24 sec). Conclusions By reducing dependence on the visual modality during resection guidance, the auditory display is well suited to become integrated in navigation systems for liver surgery.

A Survey of auditory display in image-guided interventions

“…The results of the search yielded 13 articles [4,5,9,10, 12,17,22,34,35,37–40] that met the eligibility criteria. The eligible articles cover a wide range of interventional tasks, implemented auditory display methods, evaluation styles and environments, and findings.…”

“…Willems et al [39] and Woerdeman et al [40] support volumetric lesion resection for neuronavigation. Hansen et al [17] develop an auditory display for open liver surgery for transferring a preoperatively planned initial resection path onto the surface of the liver.…”

“…Aiming to improve clinician interaction with visual displays and change view behavior was also cited in much of the literature [4,9,10,17,34,35,37,38]. Investigators commented on the necessity of clinicians to draw attention away from the situs in order to view the navigation screen.…”

“…Clinicians must remove their view from the operating situs to receive information [17], meaning important notifications might not be perceived [39], and 3-D information might not be correctly interpreted [5]. To remedy some of the deficiencies inherent in visual display, the relatively new field of auditory display [23] presents an interesting possibility for image-guided medicine.…”

Improving Precision in Navigating Laparoscopic Surgery Instruments toward a Planar Target Using Haptic and Visual Feedback

“…Bluteau et al (2010) studied the use of vibrotactile cues for guiding a tool along a 3D trajectory in traditional (open) Computer-Assisted Surgery (CAS). Similar work by Hansen et al (2013) investigated such forms of feedback for improving surgical navigation during resection tasks. Brell and Hein (2007) review work and design considerations for tactile feedback to augment surgical gestures based on preoperative information, noting that tactile feedback is a promising alternative to visual guidance as the cues are private, intuitive, and can easily code complex spatial information.…”