26 February 2019

The Interactive Technologies Lab in the University of Eastern Finland (UEF) and the University of Alberta's Surgical Simulation Research Laboratory (SSRL) have launched a collaboration to apply human factors engineering technology for training elite athletes to surgical trainees - to cut the time of operations, saving patients' lives. UEF's Dr. Roman Bednarik, who visited Alberta in January, says "We are the only two labs in the world doing this." Dr. Bednarik and the U of A's Dr. Bin Zheng are both interested in studying surgeon eye movement in the operating room (OR). Dr. Zheng's research group was the world's first to record eye tracking of surgeons during laparoscopic surgery live view in a real ORs (2010 at UBC Hospital). Dr. Bednarik developed a new eye-tracker to record surgeons' eye movement under the microscope. "Real ORs have limitations," Dr. Bednarik explains. "You can't just install something that disturbs OR procedure." Another similarity between the two teams, Dr. Zheng says, is that we all record and analyse eye-tracking data from simulated procedure: The Finnish researchers track eye movements of a neurosurgeon while the SSRL scientists monitor laproscopic surgery teams.

Dr. Bednairk says, "OR culture very different in the two countries: Finland has national champions where one surgeon performs all operations of one very specialized procedure in one hospital, compared to Canada having dozens of surgeons doing that procedure in different hospitals."

The teams compare their different data sets.

Key to surgical simulation training is understanding the difference between the eye movements of a veteran surgeon and a novice, which will allow training in gaze strategy: How a surgeon visually assesses a procedure before taking a decision. Gaze is the leading source for brain to plan a procedure.

Both teams analyze the human factors in a medical environment, including: emotions, stress, user ability, user experience, teamwork and user interface. Eye tracking is a way of monitoring how a body prepares for the task, along with heart rate.

The outcome is patient safety - the longer a procedure takes the greater the increase of infection risk, and building stronger OR teams can cut the time in the OR. Dr. Wenjing He, PhD candidate who visited Finland in February says, "Roman's lab is strong with eye tracking data processing. This is a good chance to collaborate with computing scientists."

Dr. He's work compares the eye movements and pupil synchronization of surgical teams. High performance teams showed more coordinated eye movement and pupil response.

Both the Finnish and Albertan teams monitor real gaze data and hand-eye coordination.

Dr. Paola Sanchez, an SSRL MSc candidate, who specializes in potentially training surgeons via virtual reality technology and augmented reality technology that allows surgeons to receive instructions via goggles while operating says, "Eye movement and its behaviour are wonderful measures that allow us to identify moments of difficulty during a surgical task. We are planning to use this information to create an AR smart platform to display instructions via goggles to the trainees."

SSRL's projects include:

  • Tracking surgical teams' eye synchronization in the operating room to train surgeons

  • Developing virtual reality technology to train surgeons of the future: Trainees can virtually place themselves into an operating room and perform chest punctuation procedure on a 3-dimensional digital patient. The computer will detect their performance difficulty and display instructional message to their side vision.

  • Monitoring surgeon's brainwaves under stress, to develop eye-tracking technology to train surgeons.

  • Developing augmented reality technology that allows surgeons to receive instructions via goggles while operating.

  • Developed technology to superimpose digital 3D models onto a patient's body via a projector. Motion sensors detect the movement of the patient, such as breathing and adjusts the organ positions and size in real time.

  • Developed a robotic teaching system to transfers a surgeon's hand motion from an expert to a novice.