Hybrid Navigation Interface A Comparative Study

Since the introduction of computer aided surgery, many visualisation techniques for intraoperative navigation have been proposed. Systems employing multi planar reconstruction for the visualisation of volumetric imaging data are commercially available and frequently used. In these systems, three-dimensional biomedical data is generally displayed on a two-dimensional computer monitor as orthogonal planar sections defined by the orientation of a surgical instrument. In-situ visualisation, that was introduced as an alternative approach for intraoperative navigation, superimposes three-dimensional imaging data directly on the surgical object, typically using a stereoscopic display device, e.g. a head mounted display. In this paper, we compare monitor based navigation with video see-through augmented reality visualisation regarding performance and usability. Furthermore, we compare each with a hybrid of both systems that was recently introduced. We created an experimental setup to simulate an exemplary application for trauma and orthopedic surgery and conducted the experiment with three trauma surgeons with different levels of experience using all three approaches.