IEEE Systems, Man and Cybernetics Magazine - July 2018 - 12

allowed us to quantize
the opinions and considerations of the surgeons by
a fixed numerical scale (i.e.,
from zero up to ten). The overall score of the system, considering the main previously introduce
features (e.g., usability, intuitiveness,
and effectiveness) has been about 7.5.
Comparison with Classical Systems
We have collected important information that underlines
the differences between the proposed system and the classical surgery systems. Nineteen (of the 21) surgeons
declared that despite some robotic surgery machines, like
the da Vinci Surgery System, which implements a 3-D
vision system, the IVRE offers a higher comfort level. In
fact, they have no doubts about the amenity for long operations and note that the proposed system would not tire
like the others. However, they underlined the fact that the
display of an HMD is always placed extremely close to the
eye of the user and suggested that the IVRE be systematically introduced for fast, minimally invasive surgeries. All
of the participating surgeons appreciated the control system for the tip of the endoscope. Some of the participants
specified that it may be necessary to manually adjust the
endoscope to avoid turning the neck too much while
exploring the surrounding areas. However, because a
surgeon is not alone while performing an operation on a

(a)

patient, an assistant can
conduct this action.
Future Improvements
Future improvements of the
proposed system include the use
of 360o 3-D cameras that can be substituted for the head of the endoscope,
making it unnecessary to utilize mechanical movements for
looking around inside a patient's body [12]. Concerning the
HMD, the Microsoft Hololens is becoming more prominent
and influential in different application fields (Figure 6). We
are already inserting this novel technology inside the proposed prototype and are just developing the interfaces to
integrate this device with the rest of the IVRE system. Two
of the main aspects that will be tested and compared are
the latency time and the quality of the video stream.
Conclusion
The 3-D immersive endoscope could be the new frontier of
surgery, thus allowing surgeons to dynamically interact
with the endoscope without using the hands. The results
reported in this article confirm this intuition and promote
hope that this new paradigm can be effective in a few years.
About the Authors
Danilo Avola (avola@di.uniroma1.it) earned his M.Sc.
degree in computer science from Sapienza University,
Rome, Italy, in 2002 and a Ph.D. degree in molecular and

(b)

(c)

Figure 6. (a)-(c) a surgeon performing preliminary usability tests using the microsoft Hololens.
12

IEEE SyStEmS, man, & CybErnEtICS magazInE July 2 0 1 8



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