A feasibility study on measuring bound attention during planning of a complex liver surgery (Preprint)

Abstract

The integration of advanced technologies such as Augmented Reality (AR) and Virtual Reality (VR) in surgical procedures has garnered significant attention. However, the introduction of these innovations necessitates thorough evaluation in the context of human-machine interaction. Despite their potential benefits, new technologies can complicate surgical tasks and increase the cognitive load on surgeons, potentially offsetting the intended advantages. It is crucial to assess these technologies not only for their functional improvements but also for their impact on the surgeon's workload in clinical settings.

A surgical team nowadays has to increasingly deal with more advanced technologies like AR and VR, aiming at a reduction of surgical trauma and an increase of patient safety. However, each innovation needs to be evaluated in terms of human-machine-interaction. Even if the innovation seems to bring advancement to the field it is applied in, it might make the work more complicated and increase the surgeon’s workload rather than benefitting the surgeon.

This study aims to establish a method to determine the additional workload generated by using AR or VR glasses objectively in a clinical context for the first time. For this purpose, EEG signals were recorded in a passive auditory oddball paradigm while nine participants had to perform surgical planning of liver resection in three different conditions: using (1) AR glasses, (2) VR glasses, and (3) the conventional planning software on the computer. The electrophysiological results, i.e., the potentials evokes by the auditory stimulus, were compared with the subjectively perceived stress of the participants, as determined by the NASA-TLX questionnaire.

The analysis of the EEG revealed a trend towards a lower amplitude of the N1 component as well as for the P3 component for AR condition at the central electrodes, which suggests a higher workload for the subjects while using AR glasses. In addition, EEG components in the VR condition did not reveal any noticeable differences in comparison to the EEG components of the conventional planning condition.

These results seem to indicate a lower stress level using VR glasses than AR glasses and suggests an advantage through the 3D visualization of the liver model. Furthermore, the fact that the subjectively determined results match the objectively determined results confirms the validity of the applied study design.