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Abstract

Background:

Tying surgical knots is a basic but critical skill that surgeons must master. Currently, knot tying is typically taught through instructor observation or instructional videos. These methods are either very resource consuming or offer little interactivity and customizability. Knot tying training in extended reality (XR) could address these weaknesses and improve the linking of observation and application: For example, spatial awareness and the ability to mentally rotate, i.e. imagine knots from different perspectives, affects learning performance (Brandt & Davies, 2006). XR may support spatial awareness by allowing knot tying from different perspectives superimposed on the real world.

Method:

The project GreifbAR develops an XR-based interactive knot tying training application. This application teaches the process of knot tying and provides individualized feedback based on hand pose and scene recognition. To achieve a learning-friendly design and user acceptance, the requirements of learners and experts must be considered. Therefore, based on a literature review, an online survey with 80 medical students and four interviews with experienced surgeons at Charité – Universitätsmedizin Berlin were conducted.

Initial results:

The respondents show openness towards knot tying training with XR, yet emphasize the importance of a realistic learning situations and personal guidance. They also report little prior experience with XR. The talk integrates the survey results with findings from technology acceptance research and derives implications for the design of XR-based training systems for knot tying and similar procedural tasks.

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Abstract

Background

Surgical training is primarily carried out through observation during assistance or on-site classes, by watching videos as well as by different formats of simulation. The simulation of physical presence in the operating theatre in virtual reality might complement these necessary experiences. A prerequisite is a new education concept for virtual classes that communicates the unique workflows and decision-making paths of surgical health professions (i.e. surgeons, anesthesiologists and surgical assistants) in an authentic and immersive way. For this project, media scientists, designers and surgeons worked together to develop the foundations for new ways of conveying knowledge using virtual reality in surgery.

Materials and method

A technical workflow to record and present volumetric videos of surgical interventions in a photorealistic virtual operating room was developed. Situated in the virtual reality demonstrator called VolumetricOR, users can experience and navigate through surgical workflows as if they are physically present. The concept is compared with traditional video-based formats of digital simulation in surgical training.

Results

VolumetricOR let trainees experience surgical action and workflows (a) three-dimensionally, (b) from any perspective and (c) in real scale. This improves the linking of theoretical expertise and practical application of knowledge and shifts the learning experience from observation to participation.

Discussion

Volumetric training environments allow trainees to acquire procedural knowledge before going to the operating room and could improve the efficiency and quality of the learning and training process for professional staff by communicating techniques and workflows when the possibilities of training on-site are limited.

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Abstract

Recent developments in the field of augmented reality (AR) have enabled new use cases in surgery. Initial set-up of an appropriate infrastructure for maintaining an AR surgical workflow requires investment in appropriate hardware. We compared the usability of the Microsoft HoloLens and Meta 2 head mounted displays (HMDs). Fifteen medicine students tested each device and were questioned with a variant of the System Usability Scale (SUS). Two surgeons independently tested the devices in an intraoperative setting. In our adapted SUS, ergonomics, ease of use, and visual clarity of the display did not differ significantly between HMD groups. The field of view (FOV) was smaller in the Microsoft HoloLens than the Meta 2 and significantly more study subjects felt limited through the FOV. Intraoperatively, decreased mobility due to the necessity of an AC adapter and additional computing device for the Meta 2 proved to be limiting. Object stability was rated superior in the Microsoft HoloLens than the Meta 2 by our surgeons and lead to increased use. In summary, after examination of the Meta 2 and the Microsoft HoloLens, we found key advantages in the Microsoft HoloLens which provided palpable benefits in a surgical setting.

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