Does Heads-up Display Improve Neurosurgical Endoscopic Procedures?

1. Does Heads-up Display Improve Neurosurgical Endoscopic Procedures? Abhilash Pandya1, MS, Mohammad Siadat1, MS, Lucia Zamorano1, MD dr med, Jianxing Gong1, PhD, Qing Hang Li1, MD, PhD, Jorge Alvaro Gonzalez-Martinez M.D. 1, Ramiro Perez-de la Torre M.D. 1 , James Maida2, MS 1Wayne State University, Neurosurgery Department, Detroit, MI, 2NASA/Johnson Space Center Contact Information: apandya@neurosurgery.wayne.edu (313) 966-0364 This work is partially supported by NASA grant NRA1999. Introduction: The purpose of this study was to evaluate the use of heads-up display technology for endoscopic operations. In these operations, the surgeon's hand-eye coordination is critical for success. There are very subtle issues involved with regards to very slight motions of the head and hands that can result in amplified endoscopic motions. In Figure 1 below, the surgeon is performing an endoscopic surgery using the rooms overhead monitors. Note that she is looking away from the surgical site while performing the surgery. With the heads-up display, the surgeon is able to see the surgical field as well as the endoscopic view at the same time (Figure 2). Methods: The seven test subjects of the study were asked to use an endoscope in a phantom brain and pick up five targets (distributed throughout the environment) using a heads-up display and a monitor for viewing. The Phantom was covered with a piece of sponge and a small hole was placed in the center of the sponge to create an opening in which the user would guide an endoscope. The glasses used for this study were the iglasses (LCX2) from iO Display Systems. These glasses have TV resolution (compariable to the monitor we used for the study). Results: Five of the seven subjects did the task faster using the heads-up display. On average, the subjects performed 8 percent better with the heads-up display (Figure 4). In the questionnaire provided, several of the subjects commented that the use of the heads-up display helped in the concentration of the task. It reduced external input and helped them focus on the task. Discussion / Future Work: The subject study indicated that the heads-up display may improve the focus and efficiency of the operator. In a surgical case (Figure 5), the heads up display allowed the surgeon to maintain a clear view of the surgical field. Without moving her head, she was able to glance at the endoscopic view. The surgeon commented that there was less neck strain and that she was able to guide the surgery with a little more focus and confidence. This study is still in-progress and the data collection continues. There were not enough subjects in this study to make a conclusive decision. Future work will include a more expanded study with more subjects and variation with regards to monitor placement. In addition, more complex tasks will be considered which more closely represent a surgical case. Conference Presentation: Congress of Neurological Surgeons, Oct. 2001 Figure 3: Heads-up Display vs. Monitor Viewing Figure 1: Surgeon Performing an Endoscopic Procedure Using the Over-head monitors for viewing. Figure 2: The heads-up display technology Figure 5: Surgical use of a Heads-up-Display for an Endoscopic Case Figure 4: Data from the Heads-up vs Monitor Display Study