Skip to main content

Advertisement

SpringerLink
Log in

Motion and viewing analysis during minimally invasive surgery for autostereoscopic visualization

  • Original Article
  • Published:
International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose:

Autostereoscopic 3D visualization (ASV) forms a potentially appealing alternative to stereoscopic 3D displays to help surgeons regain depth perception during minimally invasive surgery (MIS). However, the feasibility of using single-viewer ASV has not yet been demonstrated in a clinical context. The purpose of the study is to analyze the current surgical workflow and display usage and assess the potential for using ASV in MIS applications. Additionally, the study seeks to acquire a better understanding of key design requirements, such as the eye-tracking performance and the lenticular lens 3D workspace.

Methods:

Two types of gynecologic interventions were investigated. A vision-based tracking system was developed, consisting of depth cameras mounted on the displays and ArUco markers placed on the hair caps of clinicians and the wall of the operating room. This allowed simultaneous tracking of the pose of operating staff and displays.

Results:

Overall 20 surgeries were recorded, where 4 clinicians operated using 3 displays. Users were typically standing at a mean distance of 1900 mm in a range from to 1200 to 2300 mm from the display. Left–right motion was from − 600 to 658 mm. Clinicians stood on average 1000 mm from each other. The head roll angle was below 16\(^\circ \).

Conclusion:

Surgeons were looking predominantly (99%) to the same display. Observations took place from fairly well-defined places and with sufficient potential to differentiate between clinicians, suggesting that single-viewer ASV would be feasible.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Bogdanova R, Boulanger P, Zheng B (2016) Depth perception of surgeons in minimally invasive surgery. Surg Innov 23(5):515–524. https://doi.org/10.1177/1553350616639141

    Article  PubMed  Google Scholar 

  2. Gómez-Gómez E, Carrasco-Valiente J, Valero-Rosa J, Campos-Hernández JP, Anglada-Curado FJ, Carazo-Carazo JL, Font-Ugalde P, Requena-Tapia MJ (2015) Impacto de la visión 3D sobre la carga mental y el rendimiento laparoscópico en individuos sin experiencia. Actas Urológicas Españolas 39(4):229–235. https://doi.org/10.1016/J.ACURO.2014.09.008

    Article  PubMed  Google Scholar 

  3. Vickers AJ, Savage CJ, Hruza M, Tuerk I, Koenig P, Martínez-Piñeiro L, Janetschek G, Guillonneau B (2009) The surgical learning curve for laparoscopic radical prostatectomy: a retrospective cohort study. Lancet Oncol 10(5):475–480. https://doi.org/10.1016/S1470-2045(09)70079-8

    Article  PubMed  PubMed Central  Google Scholar 

  4. Yim A (2017) Title three-dimensional laparoscopy: is it as good as it looks?-a review of the literature. https://doi.org/10.21037/ales.2017.08.01

  5. Arezzo A, Vettoretto N, Francis NK, Bonino MA, Curtis NJ, Amparore D, Arolfo S, Barberio M, Boni L, Brodie R, Bouvy N, Cassinotti E, Carus T, Checcucci E, Custers P, Diana M, Jansen M, Jaspers J, Marom G, Momose K, Müller-Stich BP, Nakajima K, Nickel F, Perretta S, Porpiglia F, Sánchez-Margallo F, Sánchez-Margallo JA, Schijven M, Silecchia G, Passera R, Mintz Y (2018) The use of 3D laparoscopic imaging systems in surgery: EAES consensus development conference 2018. Surgical Endoscopy 2018 33:10 33(10), 3251–3274 . https://doi.org/10.1007/S00464-018-06612-X

  6. Urey H, Chellappan KV, Erden E, Surman P (2011) State of the art in stereoscopic and autostereoscopic displays. Proc IEEE 99(4):540–555. https://doi.org/10.1109/JPROC.2010.2098351

    Article  Google Scholar 

  7. Chen C-Y, Yang T-T, Sun W-S (2008) Optics system design applying a micro-prism array of a single lens stereo image pair. Opt Express 16(20):15495–15505. https://doi.org/10.1364/OE.16.015495

    Article  PubMed  Google Scholar 

  8. Liu J, Cui F, Li J, Shao W, Wang W, Li J, Liu M, He J (2018) Development and clinical applications of glasses-free three-dimensional (3D) display technology for thoracoscopic surgery. Ann Transl Med 6(11):214. https://doi.org/10.21037/ATM.2018.05.44

    Article  PubMed  PubMed Central  Google Scholar 

  9. Aznar-Casanova JA, Romeo A, Gómez AT, Enrile PM (2016) Visual fatigue while watching 3D stimuli from different positions. J Optom 10(3):149–160. https://doi.org/10.1016/J.OPTOM.2016.07.002

    Article  PubMed  PubMed Central  Google Scholar 

  10. Xiao Y, Schimpff S, Mackenzie C, Merrell R, Entin E, Voigt R, Jarrell B (2007) Video Technology to Advance Safety in the Operating Room and Perioperative Environment. Surg Innov 14:52–61

    Article  PubMed  Google Scholar 

  11. Azevedo-Coste C, Pissard-Gibollet R, Toupet G, Fleury É, Lucet JC, Birgand G (2019) Tracking Clinical Staff Behaviors in an Operating Room. Sensors (Basel, Switzerland) 19(10):1–14. https://doi.org/10.3390/s19102287

    Article  Google Scholar 

  12. Stenmark M, Omerbašić E, Magnusson M, Andersson V, Abrahamsson M, Tran P-K (2022) Vision-based tracking of surgical motion during live open-heart surgery. J Surg Res 271:106–116. https://doi.org/10.1016/J.JSS.2021.10.025

    Article  PubMed  Google Scholar 

  13. Birgand G, Azevedo C, Rukly S, Pissard-Gibollet R, Toupet G, Timsit JF, Lucet JC (2019) Motion-capture system to assess intraoperative staff movements and door openings: impact on surrogates of the infectious risk in surgery. Infect Control Hosp Epidemiol 40(5):566–573. https://doi.org/10.1017/ICE.2019.35/

    Article  PubMed  Google Scholar 

  14. Guest G, Namey E, Chen M (2020) A simple method to assess and report thematic saturation in qualitative research. PLoS ONE 15(5):1–17. https://doi.org/10.1371/journal.pone.0232076

    Article  CAS  Google Scholar 

  15. Garrido-Jurado S, Muñoz-Salinas R, Madrid-Cuevas FJ, Marín-Jiménez MJ (2014) Automatic generation and detection of highly reliable fiducial markers under occlusion. Pattern Recogn 47(6):2280–2292. https://doi.org/10.1016/J.PATCOG.2014.01.005

    Article  Google Scholar 

  16. Fernández A, Usamentiaga R, Carús JL, Casado R (2016) Driver distraction using visual-based sensors and algorithms. Sensors (Switzerland) 16(11):1805. https://doi.org/10.3390/S16111805

    Article  Google Scholar 

  17. Li W, Dong Q, Jia H, Zhao S, Wang Y, Xie L, Pan Q, Duan F, Liu T (2019) Training a camera to perform long-distance eye tracking by another eye-tracker. IEEE Access 7:155313–155324. https://doi.org/10.1109/ACCESS.2019.2949150

    Article  Google Scholar 

  18. Knorr S, Ide K, Kunter M, Sikora T (2012) The avoidance of visual discomfort and basic rules for producing good 3d pictures. SMPTE Motion Imaging J 121:72–79. https://doi.org/10.5594/j18236

    Article  Google Scholar 

  19. Sun G, Liu W, Fraser D, Zhang Y (2021) A possible predictor of visual discomfort of viewing stereoscopic 3d maps: the imbalance of disparity distributions. Proc Hum Factors Ergon Soc Ann Meet 65(1):1432–1436. https://doi.org/10.1177/1071181321651199

    Article  Google Scholar 

  20. Shibata T, Kim J, Hoffman D, Banks M (2011) The zone of comfort: Predicting visual discomfort with stereo displays. J Vision 11:11. https://doi.org/10.1167/11.8.11

  21. Williams SP, Parrish RV (1990) New computational control techniques and increased understanding for stereo 3-D displays. Stereoscopic displays and applications. Int Soc Opt Photon 1256:73–82. https://doi.org/10.1117/12.19891

    Article  Google Scholar 

  22. Surgical table brand comparison chart. https://avantehs.com/learn/buying-guides/surgical-table-brand-comparison Accessed 31 May 2022

  23. Principles of Room Setup and Port Placement for Minimally Invasive Surgery, Atlas of Minimally Invasive Surgical Operations, AccessSurgery, McGraw Hill Medical. https://accesssurgery.mhmedical.com/content.aspx?bookid=2403 &sectionid=187823380 Accessed 31 May 2022

Download references

Funding

This research was funded by Agentschap Innoveren en Ondernemen, Belgium, with grant number HBC.2020.2246.

Author information

Authors and Affiliations

  1. Department of Mechanical Engineering, KU Leuven, Celestijnenlaan 300, 3000, Leuven, Belgium

    Viktor Vörös & Emmanuel Vander Poorten

  2. Healthcare Division, Barco NV, Beneluxpark 21, 8500, Kortrijk, Belgium

    Viktor Vörös & Tom Kimpe

  3. Department of Obstetrics and Gynaecology, UZ Leuven, Herestraat 49, 3000, Leuven, Belgium

    Ann-Sophie Page & Jan Deprest

Authors
  1. Viktor Vörös
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ann-Sophie Page
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jan Deprest
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tom Kimpe
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Emmanuel Vander Poorten
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Viktor Vörös.

Ethics declarations

Ethical approval

The study was approved by the Ethical Committee of University Hospital Leuven, Belgium with study number S65658.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Vörös, V., Page, AS., Deprest, J. et al. Motion and viewing analysis during minimally invasive surgery for autostereoscopic visualization. Int J CARS 18, 527–535 (2023). https://doi.org/10.1007/s11548-022-02753-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11548-022-02753-6

Keywords

Search

Navigation