January 2019
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493 Reads
Image-guided surgery near anatomical or functional risk structures poses a challenging task for surgeons. To this end, surgical navigation systems that visualize the spatial relation between patient anatomy (represented by 3D images) and surgical instruments have been described. The provided 3D visualizations of these navigation systems are often complex and thus might increase the mental effort for surgeons. Therefore, an appropriate intraoperative visualization of spatial relations between surgical instruments and risk structures poses a pressing need. We propose three visualization methods to improve spatial perception in navigated surgery. A pointer ray encodes the distance between a tracked instrument tip and risk structures along the tool's main axis. A side-looking radar visualizes the distance between the instrument tip and nearby structures by a ray rotating around the tool. Virtual lighthouses visualize the distances between the instrument tip and predefined anatomical landmarks as color-coded lights flashing between the instrument tip and the landmarks. Our methods aim to encode distance information with low visual complexity. To evaluate our concepts' usefulness, we conducted a user study with 16 participants. During the study, the participants were asked to insert a pointer tool into a virtual target inside a phantom without touching nearby risk structures or boundaries. Results showed that our concepts were perceived as useful and suitable to improve distance assessment and spatial awareness of risk structures and surgical instruments. Participants were able to safely maneuver the instrument while our navigation cues increased participant confidence of successful avoidance of risk structures.