Can a Hand-Held Navigation Device Reduce Cognitive Load? A User-Centered Approach Evaluated by 18 Surgeons

Brendle, Caroline; Schütz, Laura; Esteban, Javier; Krieg, Sandro M.; Eck, Ulrich; Navab, Nassir

doi:10.1007/978-3-030-59716-0_38

Cited by 7 publications

(5 citation statements)

References 22 publications

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“…We associate the indications that the bending time could be reduced with a more intuitive guidance where no intermediate comparisons between the current and target rod shapes and no corrective bendings are necessary compared to our AR benchmark ( Wanivenhaus et al, 2019 ). Previous studies have shown that not only the navigation method is of crucial importance but that also the visualization of the guidance plays a major role in the outcome of surgical procedures ( Brendle et al, 2020 ). In this light, the smaller variability in the bending time and the number of rebending maneuvers indicates that our approach succeeds in providing clear, concise, and userindependent guidance.…”

Section: Discussionmentioning

confidence: 90%

“…Other solutions use C-arm fluoroscopy or optical markers ( Abe et al, 2013;Liu et al, 2018 ) to register a preoperative plan to the intraoperative anatomy which allows navigating entry points or trajectories of surgical tools in percutaneous vertebroplasty and hip resurfacing, respectively. ARbased surgical navigation approaches provide the surgeons with additional information in situations where human perception is limited and consequently translate highly complex procedures into simpler tasks, as demonstrated in this user-centric approach ( Brendle et al, 2020 ). This not only reduces the risk of severe intraoperative complications but also noticeably increases the precision of the surgical outcome.…”

Section: Ar-based Surgical Navigationmentioning

confidence: 98%

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Marker-free surgical navigation of rod bending using a stereo neural network and augmented reality in spinal fusion

Atzigen

Liebmann

Hoch

et al. 2022

Medical Image Analysis

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Section: Discussionmentioning

confidence: 90%

Section: Ar-based Surgical Navigationmentioning

confidence: 98%

Marker-free surgical navigation of rod bending using a stereo neural network and augmented reality in spinal fusion

Atzigen

Liebmann

Hoch

et al. 2022

Medical Image Analysis

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“…Two different visualizations for angle orientation of the surgical tool were tested with 18 physicians against the visualizations used in the clinical routine. In contrast to the early findings published by Brendle et al [ 25 ], the usability advances of the proposed concept are evaluated in depth and discussed in detail. In addition, an updated angle visualization and a preliminary usability study for a proposed depth control visualization during drilling holes into vertebrae were added to this article.…”

Section: Introductionmentioning

confidence: 95%

Usability of Graphical Visualizations on a Tool-Mounted Interface for Spine Surgery

et al. 2021

Self Cite

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Screw placement in the correct angular trajectory is one of the most intricate tasks during spinal fusion surgery. Due to the crucial role of pedicle screw placement for the outcome of the operation, spinal navigation has been introduced into the clinical routine. Despite its positive effects on the precision and safety of the surgical procedure, local separation of the navigation information and the surgical site, combined with intricate visualizations, limit the benefits of the navigation systems. Instead of a tech-driven design, a focus on usability is required in new research approaches to enable advanced and effective visualizations. This work presents a new tool-mounted interface (TMI) for pedicle screw placement. By fixing a TMI onto the surgical instrument, physical de-coupling of the anatomical target and navigation information is resolved. A total of 18 surgeons participated in a usability study comparing the TMI to the state-of-the-art visualization on an external screen. With the usage of the TMI, significant improvements in system usability (Kruskal–Wallis test p < 0.05) were achieved. A significant reduction in mental demand and overall cognitive load, measured using a NASA-TLX (p < 0.05), were observed. Moreover, a general improvement in performance was shown by means of the surgical task time (one-way ANOVA p < 0.001).

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“…Previous studies have proposed a body of AR-based navigation solutions for pedicle screw placement [40][41][42][43] . Similar approaches based on tool-mounted mobile devices have been used to provide information in the line of sight of a surgeon [44][45][46][47] . However, all these approaches have utilized visual feedback as the singular feedback modality.…”

Section: Related Studiesmentioning

confidence: 99%

Sonification as a reliable alternative to conventional visual surgical navigation

Matinfar

Salehi

Suter

et al. 2023

Sci Rep

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Despite the undeniable advantages of image-guided surgical assistance systems in terms of accuracy, such systems have not yet fully met surgeons’ needs or expectations regarding usability, time efficiency, and their integration into the surgical workflow. On the other hand, perceptual studies have shown that presenting independent but causally correlated information via multimodal feedback involving different sensory modalities can improve task performance. This article investigates an alternative method for computer-assisted surgical navigation, introduces a novel four-DOF sonification methodology for navigated pedicle screw placement, and discusses advanced solutions based on multisensory feedback. The proposed method comprises a novel four-DOF sonification solution for alignment tasks in four degrees of freedom based on frequency modulation synthesis. We compared the resulting accuracy and execution time of the proposed sonification method with visual navigation, which is currently considered the state of the art. We conducted a phantom study in which 17 surgeons executed the pedicle screw placement task in the lumbar spine, guided by either the proposed sonification-based or the traditional visual navigation method. The results demonstrated that the proposed method is as accurate as the state of the art while decreasing the surgeon’s need to focus on visual navigation displays instead of the natural focus on surgical tools and targeted anatomy during task execution.

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Can a Hand-Held Navigation Device Reduce Cognitive Load? A User-Centered Approach Evaluated by 18 Surgeons

Cited by 7 publications

References 22 publications

Marker-free surgical navigation of rod bending using a stereo neural network and augmented reality in spinal fusion

Marker-free surgical navigation of rod bending using a stereo neural network and augmented reality in spinal fusion

Usability of Graphical Visualizations on a Tool-Mounted Interface for Spine Surgery

Sonification as a reliable alternative to conventional visual surgical navigation

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