title: A touch panel surgical navigation system with automatic depth perception.
abstract: OBJECTIVE
  A touch panel navigation system may be used to enhance endoscopic surgery, especially for cauterization. We developed and tested the in vitro performance of a new touch panel navigation (TPN) system.
  
  
  METHODS
  This TPN system uses finger motion trajectories on a touch panel to control an argon plasma coagulation (APC) attached to a robot arm. Thermal papers with printed figures were soaked in saline for repeated recording and analysis of cauterized trajectory. A novice and an expert surgeon traced squares and circles displayed on the touch panel and cauterized them using the APC. Sixteen novices and eight experts cauterized squares and circles using both conventional endoscopic and TPN procedures. Six novices cauterized arcs using the endoscopic and TPN procedures 20 times a day for 5 consecutive days.
  
  
  RESULTS
  For square shapes, the offset was 5.5 mm with differences between the novice and the expert at 2 of 16 points. For circles, the offset was 5.0 mm and did not differ at any point. Task completion time for the TPN procedure was significantly longer than that for the endoscopic procedure for both squares and circles. For squares, the distance from the target for the TPN procedure was significantly smaller than that for the endoscopic procedure. For circles, the distance did not differ. There was no difference in task completion time and distance between the novices and the experts. Task completion time and distance improved significantly for the endoscopic procedure but not for the TPN procedure.
  
  
  CONCLUSIONS
  A new TPN system enabled the surgeons to accomplish continuous 3D positioning of the surgical device with automatic depth perception using finger tracing on a 2D monitor. This technology is promising for application in surgical procedures that require precise control of cauterization.
authors.affiliation: Division of Chest Surgery, Department of Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto , 602-8566, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Okada
authors.forename: Junichi
authors.initials: J
authors.lastname: Shimada
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Ito
authors.forename: Daishiro
authors.initials: D
authors.lastname: Kato
mesh_terms: D002983:Clinical Competence; D003867:Depth Perception; D004724:Endoscopy / Q000295:instrumentation*; D004867:Equipment Design; D006801:Humans; D009038:Motion; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*; D014110:Touch