Improvement in Operating Room Technical Feedback via Cost Effective Video Assessment.

IP Required: Emory IP 

Experience Required: Mechanical Design, Software and Electrical Engineering

Postgraduate surgical training is a technical and cognitive endeavor. Teaching surgeons may struggle to deliver specific and actionable feedback to trainees (residents) in the Operating Room (OR). The learning resident may experience cognitive overload due to the task burden of conceptualizing the operation as well as performing the relevant technical maneuvers. Video-based assessment (VBA) is a technique with which the learner can examine their performance asynchronously and in greater detail by reviewing a video recording of the operation. 

Numerous recording systems currently exist, each with particular limitations, including in-light cameras (the view of which may be misdirected or blocked), surgical exoscopes within the sterile field (which are cumbersome and may also be misdirected) and various types of head-mounted cameras. The latter category has several advantages, but typically involves either re-purposed integrated camera and recording devices (e.g., GoPro) or purpose-built products from medical device manufacturers (which are expensive). The high range of illumination gradients presents significant challenges in image processing, frequently delivering suboptimal views of the operative field in the resulting recordings. There is at present no low-cost head-mounted video recording device that can reliably deliver high-fidelity recordings when used in a typical OR.  

The researcher has proposed an open-source, integrated device consisting of an inexpensive single-board computer (such as a Raspberry Pi Zero), a camera unit, display / control module HAT and power source together with 3-D printed housings that can provide an integrated solution for recording video in the OR. The final assembly would consist of two units: a small, aimable camera unit with a recording indicator LED, mounted to a headstrap and connected via cable to a compute / power unit, worn at the waist with a belt clip. The underlying software would be optimized to correct the illumination gradients present due to high-intensity OR lights and provide basic controls to activate and deactivate recording as well as provide information to the user via scrolling text. The project could be expanded into a second Capstone that will allow more features, such as 1) wireless streaming of preview video to a smartphone (or live display on an integrated screen) to permit the user to aim the camera effectively; 2) transmission of the recorded video files to an authorized user (such as an externally accessible microSDXC card or wirelessly via WebDAV); 3) Audio recording with voice recognition to activate and de-activate recording; 4) integrated charging of the attached battery; 5) live-streaming capabilities with two-way audio to permit remote learning, telepresence or live consultation in low-resource settings.

 The investigators will work closely with the supervising physician, OR staff, and perform mock recordings with a GoPro in a simulated OR to gain insight into the challenges that teaching surgeons face. Supervising physician also has a modest budget to cover initial hardware. This would be the first such device available that uses commodity components and available via an open-source license. If successful, it has the potential to become rapidly adopted and enhanced by surgical educators across the world.