Empirical Evaluation of a 3D Virtual Simulator of Hysteroscopy Using Leap Motion for Gestural Interfacing.

Surgical training using 3D virtual reality simulators has become an important routine in medical education. Recent research points to Leap Motion as an exciting interface for the control of virtual surgical instruments due to its simplicity and low-cost characteristics. However, previous studies using Leap Motion only evaluated movements of the whole hand, without considering individual finger movements during the manipulation of surgical instruments. This work investigates the use of Leap Motion as an interface for the capture of basic hand and finger movements during a simulated hysteroscopy using a 3D-printed hysteroscope model. We created a virtual simulated uterine environment containing a hysteroscope controlled by movements of the hand and fingers of a user actuating on a 3D-printed model hysteroscope. The model hysteroscope was positioned in a pivot basis allowing the capture of the following basic movements: leftward/rightward, upward/downward, forward/backward, and extrusion/retraction of the virtual resection loop (which rests on the end of the virtual virtual resectoscope). The findings indicate that the arc-shaped paths of the hysteroscope's alpha plane (rightward/leftward) and beta plane (upward/downward) movements are satisfactorily simulated by the virtual reality system. Using Intraclass Correlation, was noted that the similarity between the calculated (ideal standard) and measured arcs was highly significant on both planes (r = 0.9599 on the alpha plane, and r = 0.9208 on the beta plane). Also, the forward/backward trajectory is a straight line; the pinch gesture decreases its accuracy when increase its distance from the Interaction Box of Leap Motion. The results were satisfactorily since compared with previous works, which used Leap Motion for the capture of hands-free gesturing.

An Innovative Streaming Video System With a Point-of-View Head Camera Transmission of Surgeries to Smartphones and Tablets: An Educational Utility.

PURPOSE: In order to engage medical students and residents from public health centers to utilize the telemedicine features of surgery on their own smartphones and tablets as an educational tool, an innovative streaming system was developed with the purpose of streaming live footage from open surgeries to smartphones and tablets, allowing the visualization of the surgical field from the surgeon's perspective. The current study aims to describe the results of an evaluation on level 1 of Kirkpatrick's Model for Evaluation of the streaming system usage during gynecological surgeries, based on the perception of medical students and gynecology residents. METHODS: Consisted of a live video streaming (from the surgeon's point of view) of gynecological surgeries for smartphones and tablets, one for each volunteer. The volunteers were able to connect to the local wireless network, created by the streaming system, through an access password and watch the video transmission on a web browser on their smartphones. Then, they answered a Likert-type questionnaire containing 14 items about the educational applicability of the streaming system, as well as comparing it to watching an in loco procedure. This study is formally approved by the local ethics commission (Certificate No. 53175915.7.0000.5171/2016). RESULTS: Twenty-one volunteers participated, totalizing 294 items answered, in which 94.2% were in agreement with the items affirmative, 4.1% were neutral, and only 1.7% answers corresponded to negative impressions. Cronbach's α was .82, which represents a good reliability level. Spearman's coefficients were highly significant in 4 comparisons and moderately significant in the other 20 comparisons. CONCLUSIONS: This study presents a local streaming video system of live surgeries to smartphones and tablets and shows its educational utility, low cost, and simple usage, which offers convenience and satisfactory image resolution, thus being potentially applicable in surgical teaching.