Functional Endoscopic Sinus Surgery with Head Mounted Display and Video Analysis

Endoscopic sinus surgery (FESS) is the primary approach used today for the surgical treatment of many pathologies localized in the nasal cavity, paranasal sinuses, and, in select cases, in the base of the skull. Most surgeons currently prefer to operate using the video monitor rather than an eyepiece endoscope. Although video monitors have greatly enhanced surgical endoscopy by sharing the operation field view with nurses and anesthesiologists, video monitors require the operating surgeon to be focused on the screen instead of on the patient. In this article, the use of the Head-Mounted Display (HMD) is examined in functional endoscopic sinus surgery. The integration of imaging information from various sources (i.e. endoscope camera, CT scans) digitally is proposed using an image processing pipeline. The crucial requirement for the construction of a vision system is to ensure minimum video signal latency between the source and the display (HMD). Therefore, effects of various delays were examined during simulated surgical tasks. Also, an eye-tracking-based approach was used to quantitatively assess the time that the surgeon spent focusing on the screen versus observing the patient.