BACKGROUND: During surgery, various images as well as other relevant visual information are usually shown upon request with the help of operating staff. However, the lack of direct control over the display may represent a source of stress for surgeons, particularly when fast decision making is needed. OBJECTIVE: To present the development and initial clinical testing of an innovative device that enables surgeons to have direct intangible control of the intraoperative image-displaying monitor with standardized free-hand movements. METHODS: The originally developed intangible interface named "OPECT" is based on the commercially available gaming controller KINECT (Microsoft) and dedicated actionrecognizing algorithm. The device does not require any sensors or markers fixed on the hands. Testing was done during 30 neurosurgical operations. After each procedure, surgeons completed the 5-item questionnaire for evaluation of the system performance, scaling several parameters from 1 (bad) to 5 (excellent). RESULTS: During surgical procedures, OPECT demonstrated high effectiveness and simplicity of use, excellent quality of visualized graphics, and precise recognition of the individual user profile. In all cases, the surgeons were well satisfied with performance of the device. The mean score value of answers to the questionnaire was 4.7 ± 0.2. CONCLUSION: OPECT enables the surgeon to easily have intangible control of the intraoperative image monitor by using standardized free-hand movements. The system has promising potential to be applied for various kinds of distant manipulations with the displaying visual information during human activities.
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