Improving interaction in navigated surgery by combining a pan-tilt mounted laser and a pointer with triggering

User interaction during navigated surgery is often a critical issue in the overall procedure, as several complex aspects must be considered, such as sterility, workflow, field of view, and cognitive load. This work introduces a new approach for intraoperative interaction that seamlessly fits the high surgical requirements. A navigation system, typically consisting of a tracking system and a monitor for 3D virtual models, is augmented with a tracked pointer with triggering functionality and a pan-tilt mounted laser. The pointer, which is sterile and can be applied for landmark-based organ registration, is used for wireless interaction with the monitor scene. The laser system enables the calibration of the monitor, which is out of the tracking system's range. Moreover, the laser beam can focus on any organ point defined on the virtual model, which improves targeting or visual feedback during intervention. The calibration of the laser system, monitor, and triggered pointer is achieved by an effective procedure, which can be easily repeated in operating room. The mathematical background of the calibration is based on the Levenberg-Marquardt and Umeyama's algorithms.