Recent developments in data science in general and machine learning in particular have transformed the way experts envision the future of surgery. Surgical Data Science (SDS) is a new research field that aims to improve the quality of interventional healthcare through the capture, organization, analysis and modeling of data. While an increasing number of data-driven approaches and clinical applications have been studied in the fields of radiological and clinical data science, translational success stories are still lacking in surgery. In this publication, we shed light on the underlying reasons and provide a roadmap for future advances in the field. Based on an international workshop involving leading researchers in the field of SDS, we review current practice, key achievements and initiatives as well as available standards and tools for a number of topics relevant to the field, namely (1) infrastructure for data acquisition, storage and access in the presence of regulatory constraints, (2) data annotation and sharing and (3) data analytics. We further complement this technical perspective with (4) a review of currently available SDS products and the translational progress from academia and (5) a roadmap for faster clinical translation and exploitation of the full potential of SDS, based on an international multi-round Delphi process.

There is a long-standing interest in CSCW on distributed instruction - both in how it differs from collocated instruction as well as the design of tools to reduce any deficiencies. In this study, we leveraged the unique environment of laparoscopic surgery to compare the efficacy and mechanism of instruction in a collocated and distributed condition. By implementing the same instructional technology in both conditions, we are able to evaluate the effect of distance on instruction without the confounding variable of medium of instruction. Surprisingly, our findings revealed trainees perceived a higher perceived quality of instruction in the distributed condition. Further investigation suggests that in a distributed learning environment, trainees change their behavior to attend more to the provided instructions resulting in this higher perceived quality of instruction. Finally, we discuss our findings with regards to media compensation theory, and we provide both social and technical insights on how to better support a distributed instructional process.

Multi-user input over a shared display has been shown to support group process and improve performance. However, current gesturing systems for instructional collaborative tasks limit the input to experts and overlook the needs of novices in making references on a shared display. In this paper, we investigate the effects of a single-user gesturing tool on the communication between trainer and trainees in a laparoscopic surgical training. By comparing the communication structure and content between the trainings with and without the gesturing tool, we show that the communication becomes more imbalanced and the trainees become less active when using the single-user gesturing tool. Our findings highlight the needs to grant all parties the same level of access to a shared display and suggest further directions in designing a shared display for instructional collaborative tasks.

Researchers have shown both performance drawbacks and benefits of using telepointers or similar display overlay-technologies in remote instruction; however, there is not a clear understanding of why there are these performance effects. This poses a challenge in knowing how and when to successfully use or design telepointing technologies in remote instruction. A better understanding is needed with the rise of remote workers in a wide array of industries from oil rig repair to surgery, and the proliferation of heads-up displays or telecommunications devices to support these future work practices. In this study, we explore how the information conveyed through a telepointer is taken up and acted upon by surgical trainees in a laparoscopic surgical telementoring setting. We collected audio and video data of 12 surgical trainees who performed standard laparoscopic surgical tasks on a physical model under the guidance of a surgical trainer. We investigated both action and talk to determine how the telepointer-based information was used. Our findings reveal three main challenges in using the instructional information conveyed through the telepointer including the trainees' tendency of attending to the telepointer instruction as the primary source of information. We argue that the found challenges are socio-technical in nature and require a redesign of the mentoring context as well as the technological tools.

Current generation minimally invasive surgeries present many visualization challenges, including two-dimensional representation of three-dimensional anatomy and a lack of visualization of deeply recessed structures. Coupled with the loss of tactile feedback which places greater emphasis on available visual cues, improved surgical visualization remains a long-standing need. Our response to address this need is Live Augmented Reality (Live AR), in which processed images from live radiologie scans of the surgical field are merged with optical images, accounting for spatial and temporal registration. We have demonstrated the feasibility of Live AR, but its clinical implementation is hampered by many current technical limitations. Ln this report, we have presented guidance of a simple laparoscopic maneuver completely based on computed tomography (CT) scanning and rapid 3D rendering of the acquired images in the CT room. The capability developed here and the reported results constitute a step toward the eventual goal of routine clinical implementation of Live AR.

We report on a display system to support laparoscopy by loosely coupling input sensors (e.g., cameras) with outputs (e.g., image displays). A low-latency and general-purpose computing platform is inserted between the traditionally tightly-coupled inputs and outputs of a laparoscopic surgical environment. The architecture of the proposed system provides flexibility in the fusion and augmentation of multiple input data sources and in the display of the data on a scalable large display. The performance of the described system is measured. The result indicates that our system has great potential to improve the performance of laparoscopic surgeons.

Radio frequency identification (RFlD) is a technology for automatically tracking the location of persons and objects tagged with a small radio transceiver. Its use in retail and security applications has received widespread attention in the popular press, RFID's application in hospital business processes is increasing rapidly, and a number of safety-critical clinical applications have been prototyped. In order to determine RFID 's fitness for use in safety-critical as well as more mundane perioperative processes, the operating room of the future project at the University of Maryland Medical Center evaluated six active-RFID systems. The evaluation consisted of hands-on testing of a variety of COTS systems employing the leading active-RFID technologies-802.11 RF, proprietary RF, ultra-wideband, infrared and ultrasound. In this paper we report the results of those tests and discuss their implications for the application of active-RFID technology to clinical applications

The need for technical competence brought about by the advent of minimally invasive surgery (MIS) has caused educators to re-evaluate the methods used to train surgeons and to judge their competence. Additionally, the extensive training required to become competent is an attendant problem. To help solve these problems, we have begun to develop a method for training and evaluating perioperative MIS surgical competency using an immersive virtual reality (VR) trainer for surgical preparation. This paper presents and summarizes the results of our pilot-test development of a criterion-referenced approach to evaluating performance. Because of the high degree of internal consistency of responses from master surgeons using our system, we have confidence that this approach is viable.