Hand To Hand Remote Assistance To Improve Training In Minimally Invasive Cardiac Surgery
Yuthiline CHABRY1, Didier Letourneur2, Marylou Para1, Chouki HADRI3, Stan LARROQUE3, Patrick NATAF1.
1CHU BICHAT, Paris, France, 2INSERM U1148 LVTS, Paris, France, 3LYNX, Paris, France.
BACKGROUND: Mentoring network is more efficient when the surgical trainee operates himself guided by a consultant supervisor. It is particularly relevant with Minimally Invasive Cardiac Surgery where the learning curve is binding to specific cardiac techniques not so standardized and characterized by minimally access, that doesn’t allow the bulk of two operators. This work represents a first feasibility study on remote surgical assistance given by Mixed Reality Headset in the field of Cardiac Surgery. METHODS: To test the ability of an expert to guide remotely a trainee on the surgical site, we determine an easy cardiac use case: through the intermediary of virtual hands, the expert guides the trainee to show the coronary to bypass on the heart. First step of our study was the apprehension of the hand tracking software that enables remote hand-to-hand expertise: vision by the trainee of the hands of the expert is integrated on the real surgical site. Second step was to experiment the remote assistance directly in an operating room to test the collaboration between the operator wearing mixed reality headset and the expert using hand tracking physically outside of the surgical area. RESULTS: Interactivity and simultaneous follow-through of gestures were efficient between the operator trainee and the expert remotely. The feasibility of the use of this software for surgery application was validated. The tracker enables the digital representation of the hands and then thrown it onto the screen of the Reality Mixed Headset. This virtual hand on the screen can overlay precisely an item of the vision of the operator wearing the headset. Different cut-off points rose from this experimental work : insufficient zoom lens, wireless communication requirement and the lack of fineness of hand tracking. CONCLUSIONS: Hand tracking software included in the mixed reality headset may enable the surgeon to operate with the guidance of expert hand without the bulk of another surgeon, particularly in minimally invasive cardiac surgery. Taking into account the different cut-off points, conception of the mainstream version of this mixed reality headset with improvement toward medical design shall evolve with optimum characteristics to enable surgical remote expertise and surgical formation. LEGEND: Overview in a terminal setting of the application "Remote Assistance Inclusive"
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