Design, implementation and evaluation for continuous interaction in image-guided surgery

Recent progress in the overlay and registration of digital information on the users workspace in a spatially meaningful way has allowed mixed reality (MR) to become a more effective operational medium. In the area of medical surgery, surgeons are conveyed with information such as the incisions location, regions to be avoided, diseased tissues, etc, while staying in and keeping their original working environment. The main objective of this Thesis is identifying theoretical and practical basis for how mixed reality interfaces might provide support and augmentation maximizing the continuity of interaction. We start proposing a set of design principles organized in a design space which allows to identify continuity interaction properties at an early stage of the development system. Once the abstract design possibilities have been identified and a concrete design decision has been taken, an implementational strategy can be developed. Two approaches were investigated: markerless and marker-based. The last one is used to provide surgeons with guidance on an osteotomy task in the maxillo-facial surgery. The evaluation process applies usability tests with users to validate the augmented guidance in different scenarios and to study the influence of different design variables in the final user interaction. As a result we have found a model to describe the contribution factors of each variable for the continuity of the user interaction. We suggest that this methodology can be applied mainly to those applications in which smooth connections and interactions, with virtual and real environments, are critical for the system; i.e. surgery, drivers applications or pilot simulations.