Teleproctoring with Mixed Reality: A Comparative Evaluation in the Context of Lower-Limb Fasciotomies

Speaker:  Juan Pablo Wachs – West Lafayette, IN, United States
Topic(s):  Architecture, Embedded Systems and Electronics, Robotics


Combat trauma injuries require specialized and immediate assistance. It is estimated that 1,000-2,000 lives were saved by tourniquet application during the wars in Iraq and Afghanistan using it as a first aid tool on the battlefield to prevent death from limb hemorrhage. A correct tourniquet application is necessary before performing orthopedic surgery of the extremities. However, prolonged tourniquet can lead to limb loss from ischemia and increased morbidity rates. Recently, the likelihood of compartment syndrome cases due to incorrect application of tourniquets has increased. This increment implies that frontline surgeons must be prepared to perform limb fasciotomies if the tourniquet application process results in extraneous complications to the patient. Most cases require frontline surgeons to perform fasciotomies before arrival at the medical treatment facilities to ensure proper patient outcomes; failure to perform this treatment immediately on site could result in risks as critical as limb amputation. However, most of the deployed combat surgeons lack the proper expertise to address this variety of scenarios, which implies that some form of teleproctoring is necessary to provide combat surgeons with the proper expertise in the absence of an expert orthopedic trauma surgeon on site. Telementoring techniques have been used to deliver specialized expertise to a mentee in scenarios where expertise is not readily available. Augmented reality (AR) devices have been explored as mediums to provide mentees with remote expert guidance, but their efficacy has not been validated under proper clinical evaluations. This paper presents an evaluation of our System for Telementoring with Augmented Reality (STAR) in the context of a lower-limb fasciotomies in twenty cadaveric specimens. In contrast to traditional telementoring systems, , STAR utilizes an AR Head-Mounted Display (HMD) to deliver 3D graphical instructions authored by a remote expert surgeon directly into the mentee’s field of view, without the need of shifting attention. This clinical evaluation compares our system against a scenario without mentoring that emulates the conditions frontline surgeons face when performing a fasciotomy without having the required surgical expertise.

About this Lecture

Number of Slides:  24
Duration:  20 minutes
Languages Available:  English
Last Updated: 

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