JMIR Publications

ABSTRACT

Background:

The increasingly pervasive presence of technology in the operating room (OR) raises the need to study the interaction between the surgeon and the computer system. A new generation of tools known as commercial off-the-shelf (COTS) devices that enable non-contact gesture-based human-computer interaction (HCI) are currently being explored as a solution in surgical environments.

Objective:

The aim of this systematic review was to provide an account of the state-of-the-art of COTS devices in the detection of manual gestures in surgery, and to identify their use as a simulation tool for teaching motor skills in minimally invasive surgery (MIS).

Methods:

A systematic literature review was conducted in PubMed, Embase, ScienceDirect and IEEE for articles published between January 2000 and 2016 on the use of COTS devices for gesture detection in surgical environments, and in simulation for surgical skills learning in MIS

Results:

A total of 2709 studies were identified, 76 of which met the search selection criteria. The Microsoft KinectTM and the Leap Motion ControllerTM were the most widely used COTS devices. The most common intervention was image manipulation in surgical and interventional radiology environments, followed by interaction with virtual reality environments for educational or interventional purposes; the possibility of using this technology to develop portable, low-cost simulators for skills learning in MIS was also examined. Given that the vast majority of articles found in this systematic review were proof-of-concept or prototype user and feasibility testing, we can conclude that this is a field that is still in the exploration phase in areas that require touchless manipulation in environments and settings that must adhere to asepsis and antisepsis protocols, such as angiography suites and operating rooms.

Conclusions:

COTS devices applied to hand and instrument GBIs in the field of simulation for skills learning and training in MIS could open up a promising field to achieve the ubiquitous training and pre-surgical warm-up.