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Evaluation of a Touchless Angiography Suite Computer Controller for Neuroendovascular Procedures

  • Adam A. DmytriwEmail author
  • Kevin Phan
  • Jamie Tremaine
  • Matt Strickland
  • Ivan Radovanovic
  • Timo Krings
  • Vitor M. Pereira
Original Article

Abstract

Background and Purpose

The GestSure system is an Food and Drugs Administration (FDA)-registered depth-sensing infrared device initially developed for touchless image navigation during open surgery. The goal of this study was to explore the feasibility of this technology with medical students, residents, fellows and staff neurointerventionalists, using cases of intracranial aneurysm coiling.

Material and Methods

This was a prospective cohort study of operative performance using standard keyboard and mouse against a gestural interface. A total of four medical students, six residents, six fellows and five staff neurointerventionalists were involved in the training and subsequent testing. Training involved description and demonstration of a set of gestures optimized for 3D software functions. Cases were selected from the set of patients who underwent endovascular aneurysm coiling at the Toronto Western Hospital.

Results and Conclusion

For the overall group 15/21 (71.4%) individuals learned the left anterior oblique 30 degrees (LAO30) task within 20 cases, 17/21 (80.9%) learned the aneurysm neck task within 20 cases, 16/21 (76.2%) learned the parent vessel task and 14/21 (66%) learned the neck and parent vessel (anatomical) tasks. Staff were more consistent (i.e. smallest standard deviation) amongst the groups compared to medical students and residents; however, it was noted that a significant learning effect was observed in participants across every level of medical and angiographic expertise. Touchless angiography suite control with a gestural interface is feasible for the manipulation of angiographic images for neuroendovascular procedures. Learning to use the system was rapid across any level of medical training but greatest for staff neurointerventionalists.

Keywords

Aneurysms Image-guided procedures Operative navigation Angiography Coiling 

Notes

Author Contribution

Each author contributed equally and meaningfully to the preparation of this manuscript. This reflects both time and effort invested. A.A. Dmytriw: study design, participant data acquisition, interpretation and analysis, primary manuscript preparation and editing, critical review and intellectual contribution, approval of the final version. K. Phan: expert analysis, independent statistical analysis, manuscript preparation and editing, critical review and intellectual contribution, approval of the final version. J. Tremaine: device invention and development, participant data acquisition, data analysis, manuscript preparation and editing, critical review and intellectual contribution, approval of the final version. M. Strickland: device invention and development, manuscript preparation and editing, critical review and intellectual contribution, approval of the final version. I. Radovanovic: expert neurosurgical care and analysis; expert radiological interpretation and analysis; manuscript preparation and editing, critical review and intellectual contribution; approval of the final version. T. Krings: expert neurointerventional care and analysis, expert radiological interpretation and analysis, manuscript preparation and editing, critical review and intellectual contribution, approval of the final version. V.M. Pereira: expert neurointerventional care and analysis, expert neurosurgical interpretation and analysis, manuscript preparation and editing, critical review and intellectual contribution, approval of the final version.

Conflict of interest

J. Tremaine and M. Strickland are co-inventors of GestSure. Our institutions did not at any time receive payment or services from the manufacturer for any aspect of the submitted work. A.A. Dmytriw, K. Phan, I. Radovanovic, T. Krings and V.M. Pereira declare that they have no competing interests.

Supplementary material

Video. Demonstration of a trial of aneurysm neck localization with hands-free rotation.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Medical ImagingUniversity of TorontoTorontoCanada
  2. 2.NeuroSpine Surgery Research Group (NSURG)Prince of Wales Private HospitalSydneyAustralia
  3. 3.GestSure Technologies IncTorontoCanada
  4. 4.Department of SurgeryUniversity of TorontoTorontoCanada

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