Instrument-mounted displays for reducing cognitive load during surgical navigation

Abstract

Purpose Surgical navigation systems rely on a monitor placed in the operating room to relay information. Optimal monitor placement can be challenging in crowded rooms, and it is often not possible to place the monitor directly beside the situs. The operator must split attention between the navigation system and the situs. We present an approach for needle-based interventions to provide navigational feedback directly on the instrument and close to the situs by mounting a small display onto the needle. Methods By mounting a small and lightweight smartwatch display directly onto the instrument we are able to provide navigational guidance close to the situs and directly in the operator’s field of view thereby reducing the need to switch the focus of view between the situs and the navigation system. We devise a specific variant of the established cross-hair metaphor suitable for the very limited screen space. We conduct an empirical user study comparing our approach to using a monitor and a combination of both. Results Results from the empirical user study show significant benefits for cognitive load, user preference, and general usability for the instrument-mounted display, while achieving the same level of performance in terms of time and accuracy compared to using a monitor. Conclusion We successfully demonstrate the feasibility of our approach and potential benefits. With ongoing technological advancements instrument-mounted displays might complement standard monitor setups for surgical navigation in order to lower cognitive demands and for improved usability of such systems.

Toward Holographic-Guided Surgery

“…This setup creates a situation in which the surgeon is forced to focus both on the surgical field and the virtual planning simultaneously: the switching focus problem. 17,18 Another disadvantage is that the virtual planning presented on the 1 Radboud University Medical Center, Nijmegen, Netherlands 2 Academic Medical Center, Amsterdam, Netherlands monitors is often not aligned with the viewpoint of the surgeon. The surgeon must relate these positions mentally, which may hamper his or her intuitive interpretation.…”

Comparison of Augmented Reality Display Techniques to Support Medical Needle Insertion

“…Herrlich et al investigated different alternatives to the conventional monitor-based approach. One approach mounted a small display directly on the instrument and was used to display a similar navigation aid as implemented in this work [22]. Another work used a flexible thin display that could be attached to the patient's body [21].…”

Cognitive Load Theory for debriefing simulations: implications for faculty development

“…For example, several empiric studies have shown that when instructional materials are presented in a “split-attention” format (e.g. medical diagrams with explanatory text outside of the figure instead of embedded within) then the high cognitive demand of integrating the multiple sources of information can impair learning [18, 25]. The split attention effect is just one of many “effects” described by CLT that address the way in which information is presented to learners.…”