See-Through Type 3D Head-Mounted Display–Based Surgical Microscope System for Microsurgery: A Feasibility Study

Abstract

BackgroundThe surgical microscope is used primarily for microsurgeries, which are more complicated than other surgical procedures and require delicate tasks for a long time. Therefore, during these surgical procedures, surgeons experience back and neck pain. To solve this problem, new technology, such as wearable displays, is required to help surgeons maintain comfortable postures and enjoy advanced functionality during microsurgery.ObjectiveThe objective of this study was to develop a surgical microscope system that would work with wearable devices. It would include a head-mounted display (HMD) that can offer 3D surgical images and allow a flexible and comfortable posture instead of fixed eyepieces of surgical microscope and can also provide peripheral visual field with its optical see-through function.MethodsWe designed and fabricated a surgical microscope system that incorporates a see-through type 3D HMD, and we developed an image processing software to provide better image quality. The usability of the proposed system was confirmed with preclinical examination. Seven ENT (ear, nose, and throat) surgical specialists and 8 residents performed a mock surgery—axillary lymph node dissection on a rat. They alternated between looking through the eyepieces of the surgical microscope and viewing a 3D HMD screen connected to the surgical microscope. We examined the success of the surgery and asked the specialists and residents to grade eye fatigue on a scale of 0 (none) to 6 (severe) and posture discomfort on a scale of 1 (none) to 5 (severe). Furthermore, a statistical comparison was performed using 2-tailed paired t test, and P=.00083 was considered significant.ResultsAlthough 3D HMD case showed a slightly better result regarding visual discomfort (P=.097), the average eye fatigue was not significantly different between eyepiece and 3D HMD cases (P=.79). However, the average posture discomfort, especially in neck and shoulder, was lower with 3D HMD display use than with eyepiece use (P=.00083).ConclusionsWe developed a see-through type 3D HMD–based surgical microscope system and showed through preclinical testing that the system could help reduce posture discomfort. The proposed system, with its advanced functions, could be a promising new technique for microsurgery.

Simulation-Based Estimation of the Number of Cameras Required for 3D Reconstruction in a Narrow-Baseline Multi-Camera Setup

“…Examples for this can be found in the ZEISS KINEVO ® [ 6 ] or Munich Surgical Imaging ’s ARRISCOPE [ 7 ]. Here, users observe the microscope image on a monitor [ 8 , 9 ] or a head-mounted display [ 9 , 10 , 11 ], which alleviates the previously mentioned ergonomic problems. A further advantage of streaming systems is the inclusion of remote observers, e.g., for training purposes [ 12 ].…”

Application of Mixed Reality Using Optical See-Through Head-Mounted Displays in Transforaminal Percutaneous Endoscopic Lumbar Discectomy

“…The operators completed the eye fatigue test before and after each operation. The eye fatigue test measured subjective fatigue from 0 to 7 points for tired eyes, sore or aching eyes, irritated eyes, dry eyes, eyestrain, hot or burning eyes, blurred vision, difficulty in focusing, and visual discomfort [13]. In addition, headache, dizziness, nausea, and decreased concentration were evaluated.…”

The Advantage of Using an Optical See-Through Head-Mounted Display in Ultrasonography-Guided Needle Biopsy Procedures: A Prospective Randomized Study

“…An OST-HMD enables practitioners to see the images on a monitor just in front of their eyes with their hands free. Its advantages have been reported in central venous catheterization, spinal puncture, and orthopedic and neurosurgery [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ]. Thus, when the OST-HMD is applied to US-guided needle biopsy procedures, the practitioner can perform the insertion of the needle without moving their heads or bodies, which is expected to make the puncture procedure more accurate and safer.…”