title: Development and initial clinical testing of "OPECT": an innovative device for fully intangible control of the intraoperative image-displaying monitor by the surgeon.
abstract: BACKGROUND
  During surgery, various images as well as other relevant visual information are usually shown upon request with the help of operating staff. However, the lack of direct control over the display may represent a source of stress for surgeons, particularly when fast decision making is needed.
  
  
  OBJECTIVE
  To present the development and initial clinical testing of an innovative device that enables surgeons to have direct intangible control of the intraoperative image-displaying monitor with standardized free-hand movements.
  
  
  METHODS
  The originally developed intangible interface named "OPECT" is based on the commercially available gaming controller KINECT (Microsoft) and dedicated action-recognizing algorithm. The device does not require any sensors or markers fixed on the hands. Testing was done during 30 neurosurgical operations. After each procedure, surgeons completed the 5-item questionnaire for evaluation of the system performance, scaling several parameters from 1 (bad) to 5 (excellent).
  
  
  RESULTS
  During surgical procedures, OPECT demonstrated high effectiveness and simplicity of use, excellent quality of visualized graphics, and precise recognition of the individual user profile. In all cases, the surgeons were well satisfied with performance of the device. The mean score value of answers to the questionnaire was 4.7 ± 0.2.
  
  
  CONCLUSIONS
  OPECT enables the surgeon to easily have intangible control of the intraoperative image monitor by using standardized free-hand movements. The system has promising potential to be applied for various kinds of distant manipulations with the displaying visual information during human activities.
authors.affiliation: *Faculty of Advanced Techno-Surgery, ‡Institute of Advanced Biomedical Engineering and Science, Graduate School of Medicine, Tokyo Women's Medical University, Tokyo, Japan; §Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Kitaro
authors.initials: K
authors.lastname: Yoshimitsu
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Muragaki
authors.forename: Takashi
authors.initials: T
authors.lastname: Maruyama
authors.forename: Masayuki
authors.initials: M
authors.lastname: Yamato
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Iseki
mesh_terms: D000465:Algorithms; D001921:Brain / Q000473:pathology / Q000601:surgery; D001932:Brain Neoplasms / Q000473:pathology / Q000601:surgery; D003626:Data Display; D005910:Glioma / Q000473:pathology / Q000601:surgery; D006225:Hand; D006801:Humans; D007432:Intraoperative Period; D008279:Magnetic Resonance Imaging / Q000295:instrumentation*; D009043:Motor Activity; D019635:Neurosurgical Procedures / Q000295:instrumentation*; D010363:Pattern Recognition, Automated; D010784:Photomicrography / Q000295:instrumentation*; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*; D011795:Surveys and Questionnaires; D014584:User-Computer Interface; D018910:Video Games