TY - JOUR A1 - Cramer, E. A1 - Kucharski, Alexander Bajwa A1 - Kreimeier, J. A1 - Andreß, S. A1 - Li, S. A1 - Walk, C. A1 - Merkl, F. A1 - Högl, J. A1 - Wucherer, Patrick A1 - Stefan, Philipp A1 - von Eisenhart-Rothe, Rüdiger A1 - Enste, Peter A1 - Roth, D. T1 - Requirement analysis for an AI-based AR assistance system for surgical tools in the operating room: stakeholder requirements and technical perspectives JF - International Journal of Computer Assisted Radiology and Surgery N2 - Abstract Purpose We aim to investigate the integration of augmented reality (AR) within the context of increasingly complex surgical procedures and instrument handling toward the transition to smart operating rooms (OR). In contrast to cumbersome paper-based surgical instrument manuals still used in the OR, we wish to provide surgical staff with an AR head-mounted display that provides in-situ visualization and guidance throughout the assembly process of surgical instruments. Our requirement analysis supports the development and provides guidelines for its transfer into surgical practice. Methods A three-phase user-centered design approach was applied with online interviews, an observational study, and a workshop with two focus groups with scrub nurses, circulating nurses, surgeons, manufacturers, clinic IT staff, and members of the sterilization department. The requirement analysis was based on key criteria for usability. The data were analyzed via structured content analysis. Results We identified twelve main problems with the current use of paper manuals. Major issues included sterile users’ inability to directly handle non-sterile manuals, missing details, and excessive text information, potentially delaying procedure performance. Major requirements for AR-driven guidance fall into the categories of design, practicability, control, and integration into the current workflow. Additionally, further recommendations for technical development could be obtained. Conclusion In conclusion, our insights have outlined a comprehensive spectrum of requirements that are essential for the successful implementation of an AI- and AR-driven guidance for assembling surgical instruments. The consistently appreciative evaluation by stakeholders underscores the profound potential of AR and AI technology as valuable assistance and guidance. KW - Smart operating room KW - AI surgery KW - Intelligent surgery KW - Biomedical engineering KW - Augmented Reality KW - Surgical instruments Y1 - 2024 UR - https://link.springer.com/article/10.1007/s11548-024-03193-0 U6 - https://doi.org/10.1007/s11548-024-03193-0 VL - 19 SP - 2287 EP - 2296 ER -