Virtual pointer for gaze guidance in laparoscopic surgery
Virtual pointer for gaze guidance in laparoscopic surgery
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DOI：
10.1007/s00464-019-07141-x
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发表时间：
2019-10-04
影响因子：
3.1
通讯作者：
Mentis, Helena
中科院分区：
文献类型：
--
作者：
Feng, Yuanyuan;McGowan, Hannah;Mentis, Helena
背景：腹腔镜手术的一个挑战是学习如何解释手术领域的间接切面。因此，获得专业视野--了解要看什么和要注意哪些信息--是腹腔镜培训的重要组成部分，也是培训者努力传达的内容。我们设计了一种虚拟指示器(VP)，使专家能够在术中腹腔镜视频上指向或绘制徒手草图，供新手观看。本研究旨在探讨虚拟指针在引导新手凝视模式中的作用。方法我们进行了一项反平衡的受试者内试验，比较了新手在使用虚拟指示器和标准训练条件下的凝视行为，即使用非介导性手势进行口头指导。在这项研究中，七名受训人员在一名经验丰富的外科医生的指导下进行了四项模拟的腹腔镜任务。一台Tobii Pro X3-120型眼球跟踪器被用来捕捉受训者的眼动。这些测量包括视听率，即受训者注视的频率，眼跳幅度，以及凝视力，即受训者注视的接近程度。结果虚拟指针条件下的视听率和眼跳幅度与标准条件下无显著差异。在虚拟指针条件下，与标准条件相比，受训者的注视更集中(p=0.039)，时间更长的注视更聚集(p=0.008)。结论虚拟指针器通过减少视线分散度，将视线集中在解剖靶点上，有效地提高了外科实习生在腹腔镜术训练中的即刻凝视焦点。这些结果表明，支持凝视训练的技术应该是专家驱动的，并在手术中有效地改变新手的凝视行为。
Background A challenge of laparoscopic surgery is learning how to interpret the indirect view of the operative field. Acquiring professional vision-understanding what to see and which information to attend to, is thereby an essential part of laparoscopic training and one in which trainers exert great effort to convey. We designed a virtual pointer (VP) that enables experts to point or draw free-hand sketches over an intraoperative laparoscopic video for a novice to see. This study aimed to investigate the efficacy of the virtual pointer in guiding novices' gaze patterns. Methods We conducted a counter-balanced, within-subject trial to compare the novices' gaze behaviors in laparoscopic training with the virtual pointer compared to a standard training condition, i.e., verbal instruction with un-mediated gestures. In the study, seven trainees performed four simulated laparoscopic tasks guided by an experienced surgeon as the trainer. A Tobii Pro X3-120 eye-tracker was used to capture the trainees' eye movements. The measures include fixation rate, i.e., the frequency of trainees' fixations, saccade amplitude, and fixation concentration, i.e., the closeness of trainees' fixations. Results No significant difference in fixation rate or saccade amplitude was found between the virtual pointer condition and the standard condition. In the virtual pointer condition, trainees' fixations were more concentrated (p = 0.039) and longer fixations were more clustered, compared to the Standard condition (p = 0.008). Conclusions The virtual pointer effectively improved surgical trainees' in-the-moment gaze focus during the laparoscopic training by reducing their gaze dispersion and concentrating their attention on the anatomical target. These results suggest that technologies which support gaze training should be expert-driven and intraoperative to efficiently modify novices' gaze behaviors.