gms | German Medical Science

Objective: Nowadays, intraoperative visualization of different image modalities is common, though still not quite intuitive and subsequently interrupts the surgeon's workflow. Manipulation of images requires support from the OR staff or the surgeon has to rise and move, sometimes even leave the table, grab sticks or mouses with the potential risk of contamination. We established an intuitive and touchless method for easy access and full control of all kinds of image modalities – including 3D visualization – just an arm's length apart from the surgeon to overcome these limitations.

Method: The commercially available and inexpensive Leap Motion device (Leap Motion, San Francisco, USA, ca. 69 USD), which recognizes hand movements and gestures via infrared camera, was used in combination with GameWave^® (Uwyn, Manage, Belgium), a software designed especially for the Leap device to control Windows^® or MacOS^® based platforms. A standardized user profile was developed for mighty intuitive handling of various 2D and 3D image visualization applications, such as AMIRA^®, syngo^® or OsiriX^®. The GameWave^® profile included complete live control of mouse movement as well as different intuitive and simple gestures for mouseclicks and keyboard shortcuts. Testing was done in several surgical procedures by implementing the Leap into the sterile operating field, just beside the surgeons seat – optionally including real 3D-visualization with shutter glasses.

Results: The setup was tested intraoperatively in 18 cases. With the Leap Motion device, all 2D or 3D visual data accessible by regular hardware could be viewed, managed and manipulated effortlessly without physical contact in reach of the sitting surgeon by intuitive hand movements. Five different neurosurgeons scored the setup as helpful, time-saving and very easy to use.

Conclusions: During surgical procedures, the Leap Motion device in combination with the appropriate software allows easy and intuitive touchless image manipulation especially with real 3D-data just an arm's length apart from the surgeon. This results in minimal distraction, less risk of contamination and least possible timeloss. Overall, it provides a convenient and superior approach to view and manipulate all image modalities including 3D visualization.