Tobias Huber1, Edin Hadzijusufovic1, Christian Hansen2, Markus Paschold1, Hauke Lang1, Werner Kneist1. 1. Department of General, Visceral and Transplant Surgery, University Medicine of the Johannes Gutenberg-University Mainz, Germany. 2. Institute of Simulation and Graphics, Faculty of Computer Science, Otto-von-Guericke University Magdeburg, Germany.
Abstract
INTRODUCTION: Head-mounted mixed-reality technologies may enable advanced intraoperative visualization during visceral surgery. In this technical note, we describe an innovative use of real-time mixed reality during robotic-assisted transanal total mesorectal excision. TECHNIQUE: Video signals from the robotic console and video endoscopic transanal approach were displayed on a virtual monitor using a head-up display. The surgeon, assistant, and a surgical trainee used this technique during abdominal and transanal robotic-assisted total mesorectal excision. We evaluated the feasibility and usability of this approach with the use of validated scales. RESULTS: The technical feasibility of the real-time visualization provided by the current setup was demonstrated for both the robotic and transanal parts of the surgery. The surgeon, assistant, and trainee each used the mixed-reality device for 15, 55, and 35 minutes. All participants handled the device intuitively and reported a high level of comfort during the surgery. The task load was easily manageable (task load index: <4/21), although the surgeon and assistant both noted a short delay in the real-time video. CONCLUSION: The implementation of head-mounted mixed-reality technology during robotic-assisted transanal total mesorectal excision can benefit the operating surgeon, assistant, and surgical trainee. Further improvements in display quality, connectivity, and systems integration are necessary.
INTRODUCTION: Head-mounted mixed-reality technologies may enable advanced intraoperative visualization during visceral surgery. In this technical note, we describe an innovative use of real-time mixed reality during robotic-assisted transanal total mesorectal excision. TECHNIQUE: Video signals from the robotic console and video endoscopic transanal approach were displayed on a virtual monitor using a head-up display. The surgeon, assistant, and a surgical trainee used this technique during abdominal and transanal robotic-assisted total mesorectal excision. We evaluated the feasibility and usability of this approach with the use of validated scales. RESULTS: The technical feasibility of the real-time visualization provided by the current setup was demonstrated for both the robotic and transanal parts of the surgery. The surgeon, assistant, and trainee each used the mixed-reality device for 15, 55, and 35 minutes. All participants handled the device intuitively and reported a high level of comfort during the surgery. The task load was easily manageable (task load index: <4/21), although the surgeon and assistant both noted a short delay in the real-time video. CONCLUSION: The implementation of head-mounted mixed-reality technology during robotic-assisted transanal total mesorectal excision can benefit the operating surgeon, assistant, and surgical trainee. Further improvements in display quality, connectivity, and systems integration are necessary.
Authors: Vladimir M Ivanov; Anton M Krivtsov; Sergey V Strelkov; Anton Yu Smirnov; Roman Yu Shipov; Vladimir G Grebenkov; Valery N Rumyantsev; Igor S Gheleznyak; Dmitry A Surov; Michail S Korzhuk; Valery S Koskin Journal: J Imaging Date: 2022-06-30