Evaluation of a Touchless Angiography Suite Computer Controller for Neuroendovascular Procedures

The GestSure system is an Food and Drugs Administration (FDA)-registered depth-sensing infrared device initially developed for touchless image navigation during open surgery. The goal of this study was to explore the feasibility of this technology with medical students, residents, fellows and staff neurointerventionalists, using cases of intracranial aneurysm coiling.

This was a prospective cohort study of operative performance using standard keyboard and mouse against a gestural interface. A total of four medical students, six residents, six fellows and five staff neurointerventionalists were involved in the training and subsequent testing. Training involved description and demonstration of a set of gestures optimized for 3D software functions. Cases were selected from the set of patients who underwent endovascular aneurysm coiling at the Toronto Western Hospital.

For the overall group 15/21 (71.4%) individuals learned the left anterior oblique 30 degrees (LAO30) task within 20 cases, 17/21 (80.9%) learned the aneurysm neck task within 20 cases, 16/21 (76.2%) learned the parent vessel task and 14/21 (66%) learned the neck and parent vessel (anatomical) tasks. Staff were more consistent (i.e. smallest standard deviation) amongst the groups compared to medical students and residents; however, it was noted that a significant learning effect was observed in participants across every level of medical and angiographic expertise. Touchless angiography suite control with a gestural interface is feasible for the manipulation of angiographic images for neuroendovascular procedures. Learning to use the system was rapid across any level of medical training but greatest for staff neurointerventionalists.