title: Analysis of disruptive events and precarious situations caused by interaction with neurosurgical microscope.
abstract: BACKGROUND
  Developments in micro-neurosurgical microscopes have improved operating precision and ensured the quality of outcomes. Using the stereoscopic magnified view, however, necessitates frequent manual adjustments to the microscope during an operation.
  
  
  METHODS
  This article reports on an investigation of the interaction details concerning a state-of-the-art micro-neurosurgical microscope. The video data from detailed observations of neurosurgeons' interaction patterns with the microscope were analysed to examine disruptive events caused by adjusting the microscope.
  
  
  RESULTS
  The primary findings show that interruptions caused by adjusting the microscope handgrips and mouth switch prolong the surgery time up to 10%. Surgeons, we observed, avoid interaction with the microscope's controls, settings, and configurations by working at the edge of the view, operating on a non-focused view, and assuming unergonomic body postures.
  
  
  CONCLUSIONS
  The lack of an automatic method for adjusting the microscope is a major problem that causes interruptions during micro-neurosurgery. From this understanding of disruptive events, we discuss the opportunities and limitations of interactive technologies that aim to reduce the frequency or shorten the duration of interruptions caused by microscope adjustment.
authors.affiliation: School of Computing, University of Eastern Finland, 80101, Joensuu, Finland, Shahram.eivazi@uef.fi.
authors.forename: Shahram
authors.initials: S
authors.lastname: Eivazi
authors.forename: Hoorieh
authors.initials: H
authors.lastname: Afkari
authors.forename: Roman
authors.initials: R
authors.lastname: Bednarik
authors.forename: Ville
authors.initials: V
authors.lastname: Leinonen
authors.forename: Markku
authors.initials: M
authors.lastname: Tukiainen
authors.forename: Juha E
authors.initials: JE
authors.lastname: Jääskeläinen
mesh_terms: D019544:Equipment Failure Analysis; D008866:Microsurgery / Q000295:instrumentation*; D019635:Neurosurgical Procedures / Q000295:instrumentation*; D055096:Optical Devices; D013523:Surgical Equipment