Motion and viewing analysis during minimally invasive surgery for autostereoscopic visualization

Purpose: Autostereoscopic 3D visualization (ASV) forms a potentially appealing alternative to stereoscopic 3D displays to help surgeons regain depth perception during minimally invasive surgery (MIS). However, the feasibility of using single-viewer ASV has not yet been demonstrated in a clinical context. The purpose of the study is to analyze the current surgical workflow and display usage and assess the potential for using ASV in MIS applications. Additionally, the study seeks to acquire a better understanding of key design requirements, such as the eye-tracking performance and the lenticular lens 3D workspace. Methods: Two types of gynecologic interventions were investigated. A vision-based tracking system was developed, consisting of depth cameras mounted on the displays and ArUco markers placed on the hair caps of clinicians and the wall of the operating room. This allowed simultaneous tracking of the pose of operating staff and displays. Results: Overall 20 surgeries were recorded, where 4 clinicians operated using 3 displays. Users were typically standing at a mean distance of 1900 mm in a range from to 1200 to 2300 mm from the display. Left–right motion was from − 600 to 658 mm. Clinicians stood on average 1000 mm from each other. The head roll angle was below 16\(^\circ \). Conclusion: Surgeons were looking predominantly (99%) to the same display. Observations took place from fairly well-defined places and with sufficient potential to differentiate between clinicians, suggesting that single-viewer ASV would be feasible.