Immersive Virtual Reality (VR) laparoscopy simulation is emerging to enhance the attractiveness and realism of surgical procedural training. This study analyses the usability and presence of a Virtual Operating Room (VOR) setup via user evaluation and sets out the key elements for an immersive environment during a laparoscopic procedural training.In the VOR setup, a VR headset displayed a 360-degree computer-generated Operating Room (OR) around a VR laparoscopic simulator during laparoscopy procedures. Thirty-seven surgeons and surgical trainees performed the complete cholecystectomy task in the VOR. Questionnaires (i.e., Localized Postural Discomfort scale, Questionnaire for Intuitive Use, NASA-Task Load Index, and Presence Questionnaire) followed by a semi-structured interview were used to collect the data.The participants could intuitively adapt to the VOR and were satisfied when performing their tasks (M=3.90, IQR=0.70). The participants, particularly surgical trainees, were highly engaged to accomplish the task. Despite the higher mental workload on four subscales (p <; 0.05), the surgical trainees had a lower effort of learning (4 vs 3.33, p <; 0.05) compared to surgeons. The participants experienced very slight discomfort in seven body segments (0.59-1.16). In addition, they expected improvements for team interaction and personalized experience within the setup.The VOR showed potential to become a useful tool in providing immersive training during laparoscopy procedure simulation based on the usability and presence noted in the study. Future developments of user interfaces, VOR environment, team interaction and personalization should result in improvements of the system.

In recent years it has become common practice to archive video recordings of laparoscopic surgeries for documentation purposes and for retrospective review. Typically, the videos are captured in High Definition (HD) format but encoded with legacy coding standards like MPEG-2 requiring an enormous storage capacity. In this paper we present the results of a subjective quality assessment study with 37 medical experts. We identify appropriate encoding configurations for the H.264 AVC coding standard to guarantee a visually loss less quality with a significant bitrate reduction. Further, we show that it is not necessary to capture the highest possible quality for documentation and retrospective analysis. A lower technical quality with a substantially lower bitrate still provides sufficient semantic quality. We finally present basic recommendations for an efficient encoding strategy with an appropriate tradeoff between visual quality and bitrate.