Dataset Information

HoloPointer: a virtual augmented reality pointer for laparoscopic surgery training.

ABSTRACT:

Purpose

In laparoscopic surgery training, experts guide novice physicians to desired instrument positions or indicate relevant areas of interest. These instructions are usually given via verbal communication or using physical pointing devices. To facilitate a sterile work flow and to improve training, new guiding methods are needed. This work proposes to use optical see-through augmented reality to visualize an interactive virtual pointer on the laparoscopic.

Methods

After an interdisciplinary development, the pointer's applicability and feasibility for training was evaluated and it was compared to a standard condition based on verbal and gestural communication only. In this study, ten surgical trainees were guided by an experienced trainer during cholecystectomies on a laparoscopic training simulator. All trainees completed a virtual cholecystectomy with and without the interactive virtual pointer in alternating order. Measures included procedure time, economy of movement and error rates.

Results

Results of standardized variables revealed significantly improved economy of movement (p?=?0.047) and error rates (p?=?0.047), as well as an overall improved user performance (Total z-score; p?=?0.031) in conditions using the proposed method.

Conclusion

The proposed HoloPointer is a feasible and applicable tool for laparoscopic surgery training. It improved objective performance metrics without prolongation of the task completion time in this pre-clinical setup.

SUBMITTER: Heinrich F

PROVIDER: S-EPMC7822765 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

HoloPointer: a virtual augmented reality pointer for laparoscopic surgery training.

Heinrich Florian F Huettl Florentine F Schmidt Gerd G Paschold Markus M Kneist Werner W Huber Tobias T Hansen Christian C

International journal of computer assisted radiology and surgery 20201023 1

<h4>Purpose</h4>In laparoscopic surgery training, experts guide novice physicians to desired instrument positions or indicate relevant areas of interest. These instructions are usually given via verbal communication or using physical pointing devices. To facilitate a sterile work flow and to improve training, new guiding methods are needed. This work proposes to use optical see-through augmented reality to visualize an interactive virtual pointer on the laparoscopic.<h4>Methods</h4>After an inte ...[more]

PMID: 33095424

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Project description:BackgroundThe COVID-19 pandemic challenges our ability to provide surgical education, as our ability to gather and train together has been restricted due to safety concerns. However, the importance of quality surgical education has remained. High-fidelity simulation platforms have been developed that merge virtual reality video streams to allow for remote instruction and collaboration. This study sought to validate the use of a merged virtual reality (MVR) platform for the instruction and assessment of the fundamentals of laparoscopic surgery (FLS) skills.MethodsThis was a prospective randomized controlled non-inferiority study. Thirty participants were randomized between three groups: The standard group received in-person instruction and expert feedback, the experimental group received identical training via the MVR platform, and the control group practiced on their own, but received no feedback. All participants were pre-tested for baseline performance at the beginning of the study. Change in performance was evaluated immediately after training and one month later for retention. Ordinary one-way analysis of variance was used to evaluate the effects of time, group, and time-on-group.ResultsThe pre-test confirmed baseline homogeneity between the groups. MVR was non-inferior to standard in-person training for total FLS times on either the post-test (p = 0.632) or the retention test (p = 0.829). Performance was also identical between MVR and standard training groups for each of the individual FLS tasks. Each group improved significantly in nearly all tasks after practice; however, the standard and MVR training groups both improved significantly more than controls for the ligating loop, extracorporeal suturing, intracorporeal suturing, and total FLS task training but did not reach statistical significance for peg transfer and pattern cut tasks.ConclusionThis randomized, controlled trial has demonstrated the use of an MVR platform as non-inferior to in-person instruction for the FLS program, forming the foundation for future work on remote instruction and collaboration.

Project description:Virtual reality (VR) can create safe, cost-effective, and engaging learning environments. It is commonly assumed that improvements in simulation fidelity lead to better learning outcomes. Some aspects of real environments, for example vestibular or haptic cues, are difficult to recreate in VR, but VR offers a wealth of opportunities to provide additional sensory cues in arbitrary modalities that provide task relevant information. The aim of this study was to investigate whether these cues improve user experience and learning outcomes, and, specifically, whether learning using augmented sensory cues translates into performance improvements in real environments. Participants were randomly allocated into three matched groups: Group 1 (control) was asked to perform a real tyre change only. The remaining two groups were trained in VR before performance was evaluated on the same, real tyre change task. Group 2 was trained using a conventional VR system, while Group 3 was trained in VR with augmented, task relevant, multisensory cues. Objective performance, time to completion and error number, subjective ratings of presence, perceived workload, and discomfort were recorded. The results show that both VR training paradigms improved performance for the real task. Providing additional, task-relevant cues during VR training resulted in higher objective performance during the real task. We propose a novel method to quantify the relative performance gains between training paradigms that estimates the relative gain in terms of training time. Systematic differences in subjective ratings that show comparable workload ratings, higher presence ratings and lower discomfort ratings, mirroring objective performance measures, were also observed. These findings further support the use of augmented multisensory cues in VR environments as an efficient method to enhance performance, user experience and, critically, the transfer of training from virtual to real environment scenarios.

Project description:BACKGROUND:Remote virtual rehabilitation aroused growing interest in the last decades, and its role has gained importance following the recent spread of COVID19 pandemic. The advantages of virtual reality (VR), augmented reality (AR), gamification, and telerehabilitation have been demonstrated in several medical fields. In this review, we searched the literature for studies using these technologies for orthopedic rehabilitation and analyzed studies' quality, type and field of rehabilitation, patients' characteristics, and outcomes to describe the state of the art of VR, AR, gamification, and telerehabilitation for orthopedic rehabilitation. METHODS:A comprehensive search on PubMed, Medline, Cochrane, CINAHL, and Embase databases was conducted. This review was performed according to PRISMA guidelines. Studies published between 2015 and 2020 about remote virtual rehabilitations for orthopedic patients were selected. The Methodological Index for Non-Randomized Studies (MINORS) and Cochrane Risk-of-Bias assessment tool were used for quality assessment. RESULTS:24 studies (9 randomized controlled trials (RCTs) and 15 non-randomized studies) and 2472 patients were included. Studies mainly concern telerehabilitation (56%), and to a lesser extent VR (28%), AR (28%), and gamification (16%). Remote virtual technologies were used following knee and hip arthroplasty. The majority of included patients were between 40 and 60 years old and had a university degree. Remote virtual rehabilitation was not inferior to face-to-face therapy, and physical improvements were demonstrated by increased clinical scores. Orthopedic virtual remote rehabilitation decreased costs related to transports, hospitalizations, and readmissions. CONCLUSION:The heterogeneity of included studies prevented a meta-analysis of their results. Age and social context influence adaptability to technology, and this can modify compliance to treatment and outcomes. A good relationship between patient and physiotherapist is essential for treatment compliance and new technologies are useful to maintain clinical interactions remotely. Remote virtual technologies allow the delivery of high-quality care at reduced costs. This is a necessity given the growing demand for orthopedic rehabilitation and increasing costs related to it. Future studies need to develop specific and objective methods to evaluate the clinical quality of new technologies and definitively demonstrate advantages of VR, AR, gamification, and telerehabilitation compared to face-to face orthopedic rehabilitation.

Dataset Information

HoloPointer: a virtual augmented reality pointer for laparoscopic surgery training.

Purpose

Methods

Results

Conclusion

Publications

HoloPointer: a virtual augmented reality pointer for laparoscopic surgery training.

Similar Datasets

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