Objectives: The objectives were to measure the impact of specific features of imaging devices on tasks relevant to minimally invasive surgery (MIS) and to investigate cognitive and perceptual factors in such tasks. Background: Although image-guided interventions used in MIS provide benefits for patients, they pose drawbacks for surgeons, including degraded depth perception and reduced field of view (FOV). It is important to identify design factors that affect performance. Method: In two navigation experiments, observers fed a borescope through an object until it reached a target. Task completion time and object shape judgments were measured. In a motion perception experiment, observers reported the direction of a line that moved behind an aperture. A motion illusion associated with reduced FOV was measured. Results: Navigation through an object was faster when a preview of the object's exterior was provided. Judgments about the object's shape were more accurate with a preview (compared with none) and with active viewing (compared with passive viewing). The motion illusion decreased with a rectangular or rotating octagonal viewing aperture (compared with circular). Conclusions: Navigation performance may be enhanced when surgeons develop a mental model of the surgical environment, when surgeons (rather than assistants) control the camera, and when the shape of the image is designed to reduce visual illusions. Application: Unintentional contact between surgical tools and healthy tissues may be reduced during MIS when (a) visual aids permit surgeons to maintain a mental model of the surgical environment, (b) images are bound by noncircular apertures, and (c) surgeons manually control the camera.
References
1.
Auer, L. M., & Auer, D. P. (1998). Virtual endoscopy for planning and simulation of minimally invasive neurosurgery. Neurosurgery, 43, 529–537.
2.
Baillie, J. (1991). Author's reply [Letter to the editor]. Endoscopy, 23, 305.
3.
Bruce, V., Green, P. R., & Georgeson, M. A. (1996). Visual perception: Physiology, psychology, and ecology (3rd ed.). East Sussex, England: Psychology Press.
4.
Cao, C. G. L. (2001). Designing for spatial orientation in endoscopic environments. In Proceedings of the Human Factors and Ergonomics Society 45th Annual Meeting (pp. 1259–1263). Santa Monica, CA: Human Factors and Ergonomics Society.
5.
Cao, C. G. L., & Milgram, P. (2000). Disorientation in minimal access surgery: A case study. In Proceedings of the XIVth Triennial Congress of the International Ergonomics Association and 44th Annual Meeting of the Human Factors and Ergonomics Society (pp. 4.169–4.172). Santa Monica, CA: Human Factors and Ergonomics Society.
6.
Chan, A. C. W., Chung, S. C. S., Yim, A. P. C., Lau, J. Y. W., Ng, E. K. W., & Li, A. K. C. (1997). Comparison of two-dimensional vs three-dimensional camera systems in laparoscopic surgery. Surgical Endoscopy, 11, 438–440.
7.
Chung, J. Y., & Sackier, J. M. (1998). A method of objectively evaluating improvements in laparoscopic skills. Surgical Endoscopy, 12, 1111–1116.
8.
Church, J. M. (1995). Endoscopy of the colon, rectum, and anus.New York: IGAKU-SHOIN.
9.
Coello, Y., & Grealy, M. A. (1997). Effect of size and frame of visual field on the accuracy of an aiming movement. Perception, 26, 287–300.
10.
Coren, S., Ward, L., & Enns, J. T. (1999). Sensation and perception (5th ed.). Fort Worth, TX: Harcourt Brace.
11.
Cotton, P. B., & Williams, C. B. (1996). Practical gastrointestinal endoscopy (4th ed.). Osney Mead, England: Blackwell Science.
12.
DeLucia, P. R., Hoskins, M. L., & Griswold, J. A. (2004). Laparoscopic surgery: Are multiple viewing perspectives better than one? In Proceedings of the Human Factors and Ergonomics Society 48th Annual Meeting (pp. 1661–1664). Santa Monica, CA: Human Factors and Ergonomics Society.
13.
DeLucia, P. R., & Task, H. L. (1995). Depth and collision judgment using night vision goggles. International Journal of Aviation Psychology, 5, 371–386.
14.
Digioia, A. M., Colgan, B. D., & Koerbel, N. (1998). Computer-aided surgery. In R. M. Satava (Ed.), Cybersurgery: Advanced technologies for surgical practice (pp. 121–139). New York: Wiley-Liss.
15.
Dolezal, H. (1982). Living in a world transformed: Perceptual and performatory adaptation to visual distortion.New York: Academic Press.
16.
Ellis, S. R., & Grunwald, A. (1989). Head-mounted spatial instruments: II. Synthetic reality or impossible dream (Vol. 3, pp. 521–532). In Proceedings of the NASA Conference on Space Telerobotics. Moffett Field, CA: NASA-Ames Research Center.
17.
Erhart, P., Ladd, M. E., Steiner, P., Heske, N., Dumoulin, C. L., & Debatin, J. F. (1998). Tissue-independent MR tracking of invasive devices with an internal signal source. Magnetic Resonance in Medicine, 39, 279–284.
18.
Eyal, R., & Tendick, F. (2001). Spatial ability and learning the use of an angled laparoscope in a virtual environment. In J. D. Westwood, H. M. Hoffman, G. T. Mogel, & D. Stredney (Eds.), Medicine meets virtual reality: Vol. 81. Studies in health technology and informatics (pp. 146–152). Amsterdam: IOS Press.
19.
Flach, J. M. (1990). Control with an eye for perception: Precursors to an active psychophysics. Ecological Psychology, 2, 83–111.
20.
Gallagher, A. G., Cowie, R., Crothers, I., Jordan-Black, J.-A., & Satava, R. M. (2003). An objective test of perceptual skill that predicts laparoscopic technical skill in three initial studies of laparoscopic performance. Surgical Endoscopy, 17, 1468–1471.
21.
Gallagher, A. G., Lederman, A. B., McGlade, K., Satava, R. M., & Smith, C. D. (2004). Discriminative validity of the Minimally Invasive Surgical Trainer in Virtual Reality (MIST-VR) using criteria levels based on expert performance. Surgical Endoscopy, 18, 660–665.
22.
Gallagher, A. G., Richie, K., McClure, N., & McGuigan, J. (2001). Objective psychomotor skills assessment of experienced, junior, and novice laparoscopists with virtual reality. World Journal of Surgery, 25, 1478–1483.
23.
Gibson, J. J. (1962). Observations on active touch. Psychological Review, 69, 477–491.
24.
Haluck, R. S., Webster, R. W., Snyder, A. J., Melkonian, M. G., Mohler, B. J., Dise, M. L., et al. (2001). A virtual reality surgical trainer for navigation in laparoscopic surgery. In J. D. Westwood, H. M. Hoffman, G. T. Mogel, & D. Stredney (Eds.), Medicine meets virtual reality: Vol. 81. Studies in health technology and informatics (pp. 171–176). Amsterdam: IOS Press.
25.
Harman, K. L., Humphrey, G. K., & Goodale, M. A. (1999). Active manual control of object views facilitates visual recognition. Current Biology, 9, 1315–1318.
26.
Hochberg, J. E. (1978). Perception (2nd ed.). Englewood Cliffs, NJ: Prentice-Hall.
27.
Holden, J. G., Flach, J. M., & Donchin, Y. (1999). Perceptual-motor coordination in an endoscopic surgery simulation. Surgical Endoscopy, 13, 127–132.
28.
Kantowitz, B. H. (1992). Selecting measures for human factors research. Human Factors, 34, 387–398.
29.
Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. (Eds.). (2000). To err is human: Building a safer health system.Washington, DC: National Academies Press.
30.
Levy, M. L. (1998). Virtual endoscopic simulations in neurosurgery: Technical considerations and methodology. Neurosurgery, 43, 538–548.
31.
Levy, M. L., Chen, J. C. T., Moffitt, K., Corber, Z., & McComb, J. G. (1998). Stereoscopic head-mounted display incorporated into microsurgical procedures: Technical note. Neurosurgery, 43, 392–396.
32.
MacKenzie, C. L., & Ibbotson, J. A. (2000). Survey of surgeons' use, assessment and look-ahead of endoscopic surgical technologies. In Proceedings of the XIVth Triennial Congress of the International Ergonomics Association and 44th Annual Meeting of the Human Factors and Ergonomics Society (pp. 4.165-–4.168). Santa Monica, CA: Human Factors and Ergonomics Society.
33.
McDougall, E. M., Soble, J. J., Wolf, J. S., Jr., Nakada, S. Y., Elashry, O. M., & Clayman, R. V. (1996). Comparison of three-dimensional and two-dimensional laparoscopic video systems. Journal of Endourology, 10, 371–374.
34.
McGreevy, M. W., & Ellis, S. R. (1986). The effect of perspective geometry on judged direction in spatial information instruments. Human Factors, 28, 439–456.
35.
Mitra, S., Lee, D. J., & Krile, T. F. (1990). 3-D representation from time-sequenced biomedical images using 2-D cepstrum. In Proceedings of the First Conference on Visualization in Biomedical Computing, (pp. 401–408). Los Alamitos, CA: IEEE Computer Society.
36.
Peters, T. M. (2000). Image-guided surgery: From X-rays to virtual reality. Computer Methods in Biomechanics and Biomedical Engineering, 4, 27–57.
37.
Proctor, R. W., & van Zandt, T. (1994). Human factors in simple and complex systems.Needham Heights, MA: Allyn and Bacon.
38.
Rachlin, J. A. (1995, Summer). Human factors and medical devices. Food and Drug Administration User Facility Reporting, 12, pp. 1, 3, 4.
39.
Sawyer, D. (1997). Do it by design: An introduction to human factors in medical devices.Rockville, MD: U.S. Food and Drug Administration Center for Devices and Radiological Health.
40.
Sekuler, R., Watamaniuk, S. N. J., & Blake, R. (2002). Perception of visual motion. In H. Pashler & S. Yantis (Eds.), Stevens' handbook of experimental psychology: Vol. 1. Sensation and perception (3rd ed., pp. 121–176). New York: Wiley.
41.
Seymour, N. E., Gallagher, A. G., Roman, S. A., O'Brien, M. K., Bansal, V. K., Andersen, D. K., et al. (2002). Virtual reality training improves operating room performance: Results of a randomized, double-blinded study. Annals of Surgery, 236, 458–464.
42.
Shimojo, S., Silverman, G. H., & Nakayama, K. (1989). Occlusion and the solution to the aperture problem for motion. Vision Research, 29, 619–626.
43.
Stappers, P. J. (1989). Forms can be recognized from dynamic occlusion alone. Perceptual and Motor Skills, 68, 243–251.
44.
Summers, R. M. (1997). Computers in radiology: Navigational aids for real-time virtual bronchoscopy. American Journal of Roentgenology, 168, 1165–1170.
45.
Taffinder, N., Sutton, C., Fishwick, R. J., McManus, I. C., & Darzi, A. (1998). Validation of virtual reality to teach and assess psychomotor skills in laparoscopic surgery: Results from randomized controlled studies using the MIST VR laparoscopic simulator. In J. D. Westwood, H. M. Hoffman, D. Stredney, & S. J. Weghorst (Eds.), Medicine meets virtual reality (pp. 124–130). Washington, DC: IOS Press and Ohmsha.
46.
Tendick, F., Bhoyrul, S., & Way, L. W. (1997). Comparison of laparoscopic imaging systems and conditions using a knot tying task. Computer Aided Surgery, 2, 24–33.
47.
Tendick, F., & Cavusoglu, M. C. (1997). Human-machine interfaces for minimally invasive surgery. In Proceedings of the 19th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (pp. 2771–2776). Piscataway, NJ: IEEE Engineering in Medicine and Biology Society.
48.
Tendick, F., Downes, M., Goktekin, T., Cavusoglu, M. C., Feygin, D., Wu, X., et al. (2000). A virtual environment testbed for training laparoscopic surgical skills. Presence, 9, 236–255.
49.
Tendick, F., Jennings, R. W., Tharp, G., & Stark, L. (1993). Sensing and manipulation problems in endoscopic surgery: Experiment, analysis, and observation. Presence, 2, 66–81.
50.
Treat, M. R. (1994). New technologies and future developments for endoscopic surgery. In F. L. Greene & J. L. Ponsky (Eds.), Endoscopic surgery (pp. 488–498). Philadelphia: Saunders.
51.
Tuggy, M. L. (1998). Virtual reality flexible sigmoidoscopy simulator training: Impact on resident performance. Journal of the American Board of Family Practice, 11, 426–433.
52.
U.S. Food and Drug Administration Center for Devices and Radiological Health. (1997). Human factors points to consider for IDE devices.Rockville, MD: Author.
53.
U.S. Food and Drug Administration Center for Devices and Radiological Health. (1999). Device use safety: Incorporating human factors in risk management.Rockville, MD: Author.
54.
Wanzel, K. R., Hamstra, S. J., Caminiti, M. F., Anastakis, D. J., Grober, E. D., & Reznick, R. K. (2003). Visual-spatial ability correlates with efficiency of hand motion and successful surgical performance. Surgery, 134, 750–757.
55.
Wickens, C. D. (1999). Frames of reference for navigation. In International Symposium on Attention and Performance (Ed.), Attention and performance XVII: Cognitive regulation of performance, interaction of theory and application (pp. 113–144). Cambridge, MA: MIT Press.
56.
Wickens, C. D., & Liu, Y. (1988). Codes and modalities in multiple resources: A success and a qualification. Human Factors, 30, 599–616.
57.
Williams, C., Guy, C., Gillies, D., & Saunders, B. (1993). Electronic three-dimensional imaging of intestinal endoscopy. Lancet, 341, 724–725.
58.
Woods, D. (2000, September). Human factors research to improve patient safety [Oral testimony at the National Summit on Medical Errors and Patient Safety Research]. Retrieved January 5, 2006, from the American Psychological Association Public Policy Office Web site: http://www.apa.org/ppo/issues/shumfactors.html
