BACKGROUND: Surgical displays do not show uncertainty information with respect to the position and orientation of instruments. Data is presented as though it were perfect; surgeons unaware of this uncertainty could make critical navigational mistakes. METHODS: The propagation of uncertainty to the tip of a surgical instrument is described and a novel uncertainty visualization method is proposed. An extensive study with surgeons has examined the effect of uncertainty visualization on surgical performance with pedicle screw insertion, a procedure highly sensitive to uncertain data. RESULTS: It is shown that surgical performance (time to insert screw, degree of breach of pedicle, and rotation error) is not impeded by the additional cognitive burden imposed by uncertainty visualization. CONCLUSIONS: Uncertainty can be computed in real time and visualized without adversely affecting surgical performance, and the best method of uncertainty visualization may depend upon the type of navigation display.
BACKGROUND: Surgical displays do not show uncertainty information with respect to the position and orientation of instruments. Data is presented as though it were perfect; surgeons unaware of this uncertainty could make critical navigational mistakes. METHODS: The propagation of uncertainty to the tip of a surgical instrument is described and a novel uncertainty visualization method is proposed. An extensive study with surgeons has examined the effect of uncertainty visualization on surgical performance with pedicle screw insertion, a procedure highly sensitive to uncertain data. RESULTS: It is shown that surgical performance (time to insert screw, degree of breach of pedicle, and rotation error) is not impeded by the additional cognitive burden imposed by uncertainty visualization. CONCLUSIONS: Uncertainty can be computed in real time and visualized without adversely affecting surgical performance, and the best method of uncertainty visualization may depend upon the type of navigation display.