The effect of augmented real-time image guidance on task workload during endoscopic sinus surgery

Area of Science:

• Otolaryngology
• Surgical Technology
• Medical Simulation

Background:

• Spatial awareness is critical during endoscopic sinus surgery (ESS) due to proximity to vital anatomical structures.
• An augmented, real-time image-guided surgery (ART-IGS) system was developed to provide live navigational data and proximity alerts during ablation.
• The study aimed to evaluate if ART-IGS technology reduces task workload for surgeons.

Purpose of the Study:

• To assess the impact of ART-IGS on surgeon workload during ESS.
• To evaluate the usability and effectiveness of real-time navigation and proximity alerts in surgical training.

Main Methods:

• Eight otolaryngology residents and fellows performed ESS on cadaveric specimens, with one side using conventional methods and the other using ART-IGS.
• The ART-IGS system incorporated 3D virtual endoscopic views, tool tracking, and proximity alerts after CT scanning and registration.
• Surgeon workload was assessed using the NASA Task Load Index (TLX), followed by a questionnaire and interviews.

Main Results:

• ART-IGS significantly reduced mental demand, temporal demand, effort, and frustration compared to the control group (p < 0.02).
• Perceived performance was significantly increased when using ART-IGS (p = 0.02).
• Most participants found the system accurate, minimally disruptive, and confidence-boosting, with initial optical tracking issues largely resolved.

Conclusions:

• ART-IGS effectively reduces task workload for trainees performing ESS.
• The system's live navigation and alert zones show potential as valuable intraoperative teaching tools.