Impact of heads-up display imaging on endoscopic task performance

Background and Purpose: Heads-Up Imaging goggles provide ergonomic advantages to the endourologist. This study was designed to evaluate whether heads-up display impacts task performance for ureteroscopic stone retrieval. Materials and Methods: The ability to capture a 5-mm calculus with a Cook N-Circle 2.2F stone basket from an inanimate caliceal model was tested by three experienced and three novice stone-basket operators. Visual display for initial testing for each operator was randomized to the OptiVu HD3 Heads-Up googles or a 20-inch Sony Triniton monitor (TV). Subsequent testing alternated between the two devices. Camera input was provided by the Storz telecam SL-NTSC. The HD3 was set up to align the direction of view with the operator's hands, while the TV was aligned at an angle 45° lateral and 30° superior to the operator's direction of view to approximate the traditional room set-up for an endourologic procedure. Each operator performed live basketing trials with each display set-up. Results: Expert operators retrieved calculi more rapidly (9.2 ± 5.9 seconds) than novice operators (50.7 ± 48.9 seconds), irrespective of whether a TV monitor or goggle display was utilized as the imaging modality. No significant differences were noted in task performance between the two imaging modalities for the expert (P = b0.60), novice (P = 0.77), or overall (P = 0.91) groups. Conclusion: The Optiview Heads-Up goggle display system does not offer advantages in task performance with specific regard to the ability to capture stone fragments with baskets.