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Virtual pointer for gaze guidance in laparoscopic surgery

机译：腹腔镜手术中用于凝视引导的虚拟指针

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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.
机译：背景 腹腔镜手术的一个挑战是学习如何解释手术区域的间接视图。因此，获得专业的视力——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，也是培训师努力传达的一部分。我们设计了一个虚拟指针（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注视模式方面的功效。方法 我们进行了一项平衡的受试者内试验，将新手在腹腔镜训练中使用虚拟指针的凝视行为与标准训练条件（即使用非中介手势的口头指导）进行比较。在这项研究中，七名学员在经验丰富的外科医生的指导下执行了四项模拟腹腔镜任务。使用Tobii Pro X3-120眼动仪捕捉学员的眼球运动。这些措施包括注视率，即受训者注视的频率、扫视幅度和注视浓度，即受训者注视的紧密程度。结果 虚拟指针条件与标准条件的注视率和扫视幅度差异无统计学意义。在虚拟指针条件下，受训者的注视更加集中（p = 0.039），与标准条件（p = 0.008）相比，较长的注视点更聚集。结论 虚拟指针通过减少手术受训者凝视分散，将注意力集中在解剖目标上，有效改善了外科实习生在腹腔镜训练中的即时凝视焦点。这些结果表明，支持凝视训练的技术应该是专家驱动的和术中，以有效地改变新手的凝视行为。

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