Development and Assessment of a Serious Game to Study Reduced Field of View in Keyhole Surgery (Preprint)

Abstract

During keyhole surgery the surgeon is required to perform highly demanding tasks whilst only able to see part of the patient's anatomy. This limited field of view is very widely cited as a key limitation of keyhole surgery and many computational methods to overcome limited field of view have been proposed. However, the precise effects of limited field of view on task performance remain unknown due to a lack of tools to effectively study the effects of limited field of view.

This paper describes our work on developing a serious game to test the effect of limited field of view on task performance. The development of a serious game that can be played by a wide range of participants will enable to gather quantitative data on the effects of reduced field of view on task performance. These data can inform future development of technologies to aid the surgeon in reducing the impact of limited field of view on clinical outcomes for the patient. As the game is fully opensource it may also be adapted and used by other researchers to study related problems.

We implemented an opensource serious game in JavaScript, inspired by the surgical task of selectively cauterising blood vessels during twin to twin transfusion surgery. During the game the player is required to identify and cut the correct blood vessel under different fields of view, and with different levels of vascular complexity. We performed a quantitative analysis of task performance time under different conditions and a formative analysis of the game using participant questionnaires.

We recruited 25 players to test the game and recorded their task performance time, accuracy, and qualitative metrics. Reducing the field of view resulting in participants taking statistically significantly longer (16.4 vs 9.8 seconds, p=0.05) to perform otherwise identical tasks. Participants found the game engaging and agreed that the game enhanced their understanding of limited field of view during keyhole surgery.

We recruited 25 players to test the game and recorded their task performance time, accuracy, and qualitative metrics. Reducing the field of view resulting in participants taking statistically significantly longer (16.4 vs 9.8 seconds, p=0.05) to perform otherwise identical tasks. Participants found the game engaging and agreed that the game enhanced their understanding of limited field of view during keyhole surgery.

This paper does not include an RCT.