Comparative usability and performance evaluation of surgeon interfaces in laser phonomicrosurgery

Robot-assisted surgical procedures, such as Laser Phonomicrosurgery (LP), suffer from susceptibility to variation in surgeon skill and equipment characteristics. Ergonomic and human-centered approaches acquire increased importance in the design of surgeon-machine interfaces. This paper proposes a protocol for comparative evaluation of surgeon-machine interfaces based on two criteria: (i) the subjective evaluation of their usability using questionnaires, and (ii) the objective evaluation of their performance using an imaging-based feature extraction method. Two interfaces in LP, the traditional ("AcuBlade") interface and the novel ("Virtual Scalpel") interface, were evaluated to demonstrate the effectiveness of the proposed scheme. A series of experimental trials were conducted using the interfaces in surgery-like tasks in a controlled environment. The subjective evaluation pointed to the superiority of the Virtual Scalpel interface (score: 83.06) in terms of confidence and ease of use, and learnability, over the AcuBlade interface (score: 65.56). The objective evaluation showed the Virtual Scalpel interface having an overall score (55.96) significantly superior to the AcuBlade (51.37). It is thus shown that the multidimensional evaluation approach allowed to clearly distinguish between levels of perceived usability and effective performance of surgeon-machine interfaces from a user-centered perspective