A Virtual Joystick as a Novel Interaction Modality for Surgeon-Computer Interaction During Computer-Assisted Surgical Procedures

Interacting with a computer system in the operating room (OR) can be a frustrating experience for a surgeon, who currently has to verbally delegate to an assistant every computer interaction task. This indirect mode of interaction is time consuming, error prone and can lead to poor usability of OR computer systems. This thesis describes the design and evaluation of a joystick-like device that allows direct surgeon control of the computer in the OR. The device was tested extensively in comparison to a mouse and delegated dictation with seven surgeons, eleven residents, and five graduate students. The device contains no electronic parts, is easy to use, is unobtrusive, has no physical connection to the computer and makes use of an existing tool in the OR. We performed a user study to determine its effectiveness in allowing a user to perform all the tasks they would be expected to perform on an OR computer system during a computer-assisted surgery. Dictation was found to be superior to the joystick in qualitative measures, but the joystick was preferred over dictation in user satisfaction responses. The mouse outperformed both joystick and dictation, but it is not a readily accepted modality in the OR.

Developing Single-Laser Sources for Multimodal Coherent Anti-Stokes Raman Scattering Microscopy

Coherent anti-Stokes Raman scattering (CARS) microscopy has developed rapidly and is opening the door to new types of experiments. This work describes the development of new laser sources for CARS microscopy and their use for different applications. It is specifically focused on multimodal nonlinear optical microscopy—the simultaneous combination of different imaging techniques. This allows us to address a diverse range of applications, such as the study of biomaterials, fluid inclusions, atherosclerosis, hepatitis C infection in cells, and ice formation in cells. For these applications new laser sources are developed that allow for practical multimodal imaging. For example, it is shown that using a single Ti:sapphire oscillator with a photonic crystal fiber, it is possible to develop a versatile multimodal imaging system using optimally chirped laser pulses. This system can perform simultaneous two photon excited fluorescence, second harmonic generation, and CARS microscopy. The versatility of the system is further demonstrated by showing that it is possible to probe different Raman modes using CARS microscopy simply by changing a time delay between the excitation beams. Using optimally chirped pulses also enables further simplification of the laser system required by using a single fiber laser combined with nonlinear optical fibers to perform effective multimodal imaging. While these sources are useful for practical multimodal imaging, it is believed that for further improvements in CARS microscopy sensitivity, new excitation schemes are necessary. This has led to the design of a new, high power, extended cavity oscillator that should be capable of implementing new excitation schemes for CARS microscopy as well as other techniques. Our interest in multimodal imaging has led us to other areas of research as well. For example, a fiber-coupling scheme for signal collection in the forward direction is demonstrated that allows for fluorescence lifetime imaging without significant temporal distortion. Also highlighted is an imaging artifact that is unique to CARS microscopy that can alter image interpretation, especially when using multimodal imaging. By combining expertise in nonlinear optics, laser development, fiber optics, and microscopy, we have developed systems and techniques that will be of benefit for multimodal CARS microscopy.