C-Arm Unleashed: Intuitive Inter-Operative Positioning of C-Arms Using Wearable Gesture Detection

Imaging equipment used in surgical and interventional procedures requires accurate positioning and often anticipative or very reactive intra-operative adjustment to ensure optimal clinical outcomes. The common way to control such imaging systems is joysticks and buttons operated by the physicians themselves or, more frequently, by their radiographers (or radiologic technologists). However, in the latter case, communication between both can be easily affected by the loud and distracting environment of the operating room, the lack of experience of the radiographers, or the stressful emergency character of certain situations. Miscommunication and misunderstandings concerning the positioning of the imaging equipment can lead to suboptimal image guidance, longer procedure times, and even clinical mistakes. Different alternative concepts, where physicians are able to control the imaging systems by themselves and without assistance, have already been tested and reported. However, these approaches, including voice control, were neither robust nor safe enough to be adapted into clinical routine. We introduce a new wearable EMG- and IMU-based intuitive control concept for imaging systems, especially mobile surgical C-arms, to address the mentioned shortcomings. The developed control algorithm was evaluated in a TAC test with a simulation. Apart from the TAC test, we also assessed workload, usability, likeability, and perceived safety.