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F Kishino

Publications and source records attributed to F Kishino.

5 recordsLinked to original sources
PubMed1998

Spatial perception in macroscopic and microscopic surgical manipulations: differences between experienced and inexperienced surgeons.

The spatial perceptions of the phantom surgical field with the naked eye and under the surgical microscope were analyzed in a group of experienced and a group of inexperienced neurosurgeons. The phantom surgical field contained a start point, a virtual gate, and a target point. The virtual gate was an invisible zone arbitrarily set in the phantom surgical field. The examinees were first instructed regarding the position of the invisible virtual gate. Then they were asked to point consecutively to the three points with a suction tube under three different circumstances: with the naked eye, under the microscope, and by watching a navigation monitor. A surgical navigator was used to record the three-dimensional position of the suction tip. The pointing deviation from the suction tip to the center of the virtual gate was evaluated. The pointing accuracy with the naked eye did not differ between the two groups, but that under the microscope was significantly better in the experienced group than in the inexperienced group. Fluctuations in pointing deviation were significantly greater in the inexperienced neurosurgeons, especially with the microscope. Further analysis demonstrated that these differences were attributable to poorer depth perception of the phantom surgical space among the inexperienced neurosurgeons.

Clinical Competence↗
PubMed1998

[Discrepancy between surgeon's binocular parallax perception and manipulation in the neurosurgical operation].

The application of virtual reality (VR) to the neurosurgical field has been increasing recently, however, the relation between the surgeon and the VR environment is rarely studied. We examined the trajectory of a surgical instrument during manipulation of a virtual object using a video-see-through microscope and a neurosurgical navigator (CANS Navigator) to find better surgeon-microscope interface. A resin cylindrical phantom was produced representing the surgical field, which included two 3 dimensionally arranged small spheres and a virtual 'gate'. The phantom was fixed and set under the microscope with a skull clamp mimicking conditions in an ordinary craniotomy. Firstly, the binocular parallax perception under microscope was examined. Experienced and inexperienced neurosurgeons were asked to learn the position of the virtual 'gate' for 3 minutes. Then, after 5 minutes to point with the navigator probe (suction tube), under various conditions; under the naked eyes, under the microscope, under the navigator without observing the phantom, and under the microscope with picture in picture (PIP) display of the navigational image. The positions of the suction tube were recorded at real time into the navigator for later analysis. Secondly, the task performance in this VR environment was studied by analyzing the trajectory of the suction tube from one sphere to the other sphere passing the virtual 'gate' under various conditions. A significant difference in pointing precision between experienced and inexperienced neurosurgeons was able to be observed only under microscope. This difference was mainly derived from overestimation of the depth of the virtual 'gate' by the inexperienced neurosurgeons. Among the above conditions, pointing under the microscope with PIP was able to be performed the most precisely and the most promptly. This study disclosed the presence of stereoscopic distortion in the microscope. The PIP display of the navigational image in the microscopic view remarkably improved the task performance, which could be accounted for by the correction of the somewhat distorted binocular parallax perception under the neurosurgical microscope by the provision of another visual key.

Brain↗