Spatial orientation in pathway surgery
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In the field of minimally invasive surgery, specifically in pathway surgery (i.e. minimal invasive procedures carried out transluminally or through instrument-created pathways), spatial disorientation is a common experience to endoscopists. In this article, two effects that may cause spatial disorientation in pathway surgery, ‘control-display compatibility’ and ‘local disorientation’, were studied.
A custom-developed simulator Endo-PaC was developed and used for mimicking pathway surgical scenarios. In Study 1, two ways of control-display alignment, normal mapping and mirrored mapping, were tested in combination with two control devices, thumb control and wrist control, in an orienting task using Endo-PaC. In Study 2, a tethered viewpoint was added to the virtual instrument tip. It was hypothesized that the visible tip would provide a cue of orientating direction in the reference frame during the instrument navigation. In both studies, novice participants were involved, and their performance was evaluated with regard to task time, path length travelled by the virtual tip, time and number of warnings, and subjective workload and personal preference.
In Study 1, normal-thumb and normal-wrist mapping yielded significantly lower means than mirrored-thumb and mirrored-wrist control for all investigated objective and subjective performance measurements. Out of 24 participants, 20 participants preferred normal control mapping. In Study 2, participants performed the task in shorter time and with shorter path length when the tip was visible tip on the monitor using a tethered viewpoint, but with a lower number and time of warnings without a visible tip.
The results of our studies show that eliminating the visual-display misalignment would greatly improve novice participants’ performance, reduce the training time and their cognitive workload. A visible tip on the monitor would provide strong direction cue and shorten the performance time, but might introduce collision errors to novices and therefore requires longer training time.
KeywordsInstruments Steerable instrument Spatial orientation
The research was funded by the Marie Curie Initial Training Network project IIIOS (Integrated Interventional Imaging Operation System, Project 238802) and carried out at the department BioMechanical Engineering of Delft University of Technology. The authors want to thank all the participants as well as Filip Jelinek and David Jager for designing and manufacturing the Endo-PaC.
The authors Chunman Fan, Dimitra Dodou, Paul Breedveld and Jenny Dankelman have no conflicts of interest or financial ties to disclose.
- 2.Shahinian HK, Kabil MS, Jarrahy R (2008) Endoscopic skull base surgery: a comprehensive guide with illustrative cases. Humana Press, TotowaGoogle Scholar
- 3.Cao CG, Milgram P (2000) Disorientation in minimal access surgery: a case study. In: Proceedings of the Human Factors and Ergonomics Society Annual Meeting, SAGE Publications, pp 169–172Google Scholar
- 6.Hollands JG, Wickens CD (1999) Engineering psychology and human performance. Prentice Hall, Upper Saddle RiverGoogle Scholar
- 7.Smith RL, Stuart MA (1989) The effects of spatially displaced visual feedback on remote manipulator performance. In: Proceedings of the Human Factors and Ergonomics Society Annual Meeting, SAGE Publications, pp 1430–1434Google Scholar
- 8.Brooks TL, Ince I (1992) Operator vision aids for telerobotic assembly and servicing in space. In: Proceedings of the IEEE International Conference on Robotics and Automation, pp 886–891Google Scholar
- 9.Gray SV, Wilson JR, Syan CS (1992) Human control of robot motion: orientation, perception and compatibility. In: Human-robot interaction. Taylor & Francis, London, pp 48–64Google Scholar
- 11.McKee GT, Schenker PS (1993) Nonanthropomorphic viewing for teleoperation. In: Optical tools for manufacturing and advanced automation. International Society for Optics and Photonics, pp 282–291Google Scholar
- 13.Hills JW, Green PS, Jensen JF, Gorfu Y, Shah AS (1994) Telepresence surgery demonstration system. In: Proceedings of the IEEE International Conference on Robotics and Automation, pp 2302–2307Google Scholar
- 16.De Winter JCF (2014) Controversy in human factors constructs and the explosive use of the NASA TLX: a measurement perspective. Cogn Technol Work 16:289–297Google Scholar
- 18.Wickens CD, Vincow M, Yeh M (2005) Design application of visual spatial thinking: the importance of frame of reference. In: Shah P, Miyake A (eds) The Cambridge handbook of visuospatial thinking, Cambridge University Press, pp 383–425Google Scholar
- 19.Winckens CD, Hollands JG, Parasuraman R, Banbury S (2012) Engineering psychology and human performance, 4th edn. Pearson, BostonGoogle Scholar
- 21.Wang W, Milgram P (2001) Dynamic viewpoint tethering for navigation in large-scale virtual environments. In: Proceedings of the Human Factors and Ergonomics Society Annual Meeting, SAGE Publications, pp 1862–1866Google Scholar
- 22.Wang W, Milgram P (2003) Effects of viewpoint displacement on navigational performance in virtual environments. In: Proceedings of the Human Factors and Ergonomics Society Annual Meeting, SAGE Publications, pp 139–143Google Scholar
- 23.Golledge RG (1999) Human wayfinding and cognitive maps. In: Golledge RG (ed) Wayfinding behaviour: cognitive mapping and other spatial processes, Johns Hopkins Press, Baltimore, pp 5–45Google Scholar
- 26.Cao CGL (2001) Designing for spatial orientation in endoscopic environments. In: Proceedings of the Human Factors and Ergonomics Society Annual Meeting, SAGE Publications, pp 1259–1263Google Scholar
- 30.Haluck RS, Webster RW, Snyder AJ, Melkonian MG, Mohler BJ, Dise ML, Lefever A (2003) A virtual reality surgical trainer for navigation in laparoscopic surgery. Med Meets Virtual Real 105(2):119–131Google Scholar
- 33.Zazzarini CC, Pansini A, Cerveri P, Zaltieri R, Lavizzari D (2011) Design of a robotic endoscope for mini invasive surgery. In: ASME 2011 International Design Engineering Technical Conferences and Computers and Information in Engineering Conference. American Society of Mechanical Engineers, pp 771–777Google Scholar
- 34.Inoue H, Okabe S, Takeshita K, Muraoka Y, Yoneshima H, Endo M (1993) Colonoscopy using a transparent plastic cap. Gastroenterol Endosc 35:378–381Google Scholar