Clin Orthop Surg.  2021 Sep;13(3):436-446. 10.4055/cios20004.

Touchless Control of Picture Archiving and Communication System in Operating Room Environment: A Comparative Study of Input Methods

  • 1Department of Orthopedic Surgery, Ajou University School of Medicine, Ajou Medical Center, Suwon, Korea
  • 2Department of Orthopedic Surgery, Eulji University Hospital, Daejeon, Korea
  • 3Department of Orthopaedic Surgery, Gyeongsang National University Hospital, Jinju, Korea
  • 4Department of Orthopedic Surgery, Yeungnam University Hospital, Daegu, Korea


The advancement of computer information technology would maximize its potential in operating rooms with touchless input devices. A picture archiving and communication system (PACS) was compared with a touchless input device (LMC-GW), relaying to another person to control a mouse through verbal guidance, and directly controlling a mouse.
Participants (n = 34; mean age, 29.6 years) were prospectively enrolled and given nine scenarios to compare the three methods. Each scenario consisted of eight tasks, which required 6 essential functions of PACS. Time elapsed and measurement values were recorded for objective evaluation, while subjective evaluation was conducted with a questionnaire.
In all 8 tasks, manipulation using the mouse took significantly less time than the other methods (all p < 0.05). Study selection, panning, zooming, scrolling, distance measuring, and leg length measurement took significantly less time when LMC-GW was used compared to relaying to another person (all p < 0.01), whereas there were no significant differences in time required for measuring the angles and windowing. Although the touchless input device provided higher accessibility and lower contamination risk, it was more difficult to handle than the other input methods (all p < 0.01).
The touchless input device provided superior or equal performance to the method of verbal instruction in the environment of operating room. Surgeons agreed that the device would be helpful for manipulating PACS in operating rooms with less contamination risk and disturbance of workflow. The touchless input device can be an alternative option for direct manipulation of a mouse in operation rooms in the future.


Touchless; Mouse; Picture archiving and communication system; Operating room
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