Analysis of disruptive events and precarious situations caused by interaction with neurosurgical microscope

Abstract

Background

Developments in micro-neurosurgical microscopes have improved operating precision and ensured the quality of outcomes. Using the stereoscopic magnified view, however, necessitates frequent manual adjustments to the microscope during an operation.

Method

This article reports on an investigation of the interaction details concerning a state-of-the-art micro-neurosurgical microscope. The video data from detailed observations of neurosurgeons’ interaction patterns with the microscope were analysed to examine disruptive events caused by adjusting the microscope.

Results

The primary findings show that interruptions caused by adjusting the microscope handgrips and mouth switch prolong the surgery time up to 10 %. Surgeons, we observed, avoid interaction with the microscope’s controls, settings, and configurations by working at the edge of the view, operating on a non-focused view, and assuming unergonomic body postures.

Conclusions

The lack of an automatic method for adjusting the microscope is a major problem that causes interruptions during micro-neurosurgery. From this understanding of disruptive events, we discuss the opportunities and limitations of interactive technologies that aim to reduce the frequency or shorten the duration of interruptions caused by microscope adjustment.

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All authors certify that they have NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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Correspondence to Shahram Eivazi.

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Eivazi, S., Afkari, H., Bednarik, R. et al. Analysis of disruptive events and precarious situations caused by interaction with neurosurgical microscope. Acta Neurochir 157, 1147–1154 (2015). https://doi.org/10.1007/s00701-015-2433-5

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Keywords

  • Medical practice
  • Microscope use in the OR
  • Interruption
  • Interaction with microscope
  • Micro-neurosurgery