Verbeterde chirurgische 3D-perceptie door autostereoscopische visualisatie

This doctoral research is focused on the development of autostereoscopic 3D visualization for medical applications. Advancements in high-resolution 3D endoscopy and 3D reconstruction from CT scans have led to an increase in 3D content in minimally invasive surgery (MIS) and image-guided therapy (IGT). However, when displayed on 2D screens, essential depth information is often lost. Autostereoscopic visualization (ASV) offers a promising solution by rendering 3D content directly to the user's viewpoint without the need for wearable hardware, thanks to an embedded eye-tracking system and lenticular lens technology. Being a relatively new technology, there is still limited research and understanding of the specific clinical requirements for this technology and its potential benefits. A motion and viewing analysis of the operating staff during gynaecologic MIS was conducted to identify the clinical and functional requirements of ASV. A risk assessment conducted on the hardware components specific to ASV identified potential hazardous situations leading to further display requirements for risk mitigation. To verify that the technology complies with the identified requirements, novel display characterization methods were developed to assess crosstalk and eye-tracking performance across the viewing zone, assessing how errors in eye-tracking or interpupillary distance (IPD) affect user experience. Additionally, a tool using Unreal Engine and MetaHumans was created to generate synthetic clinical eye-tracking datasets for pre-clinical validation. Multiple user selection schemes were also evaluated to estimate the primary user. For validation, mixed reality simulators were created to compare ASV with 2D visualization during laparoscopic navigation and assess a novel hybrid 3D AR visualization rendering for IGT. This hybrid 3D AR rendering method integrates 2D modalities like fluoroscopy with stereo 3D AR content on an ASV display, that was assessed within a user study involving cardiologists. The findings and developments of this thesis helped to bridge the gap in the state-of-the-art of clinical ASV. The next steps include the standardization of the developed characterization methods, further clinical studies to showcase the added value of ASV and entering the market after regulatory clearance either as a standalone display or integrated in other devices.