How can I improve the UX of the surgical navigation in order to get an intuitive interface?

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Direct collaborators: Matteo Fusaglia, Ruben van Veen, Jasper Smit

Netherlands Cancer Institute // Interaction design, Visual design, UX research, Tester

Project duration: 4.5 months

After my half year stop and after my internship for half a year I was now eligible to finish my school career. While I had contact with multiple companies there was one project that just pulled me towards itself. It was posted on my school's internship bank so I contacted the people that posted it, and got the chance to work on this project. During this project I had 2 supervisors, those were Matteo (developer) and Ruben (researcher). Jasper (technical physician) helped by getting directly involved with the feedback sessions I had during this project.


I was asked to create an interface for a system that didn't have an interface yet and that was still in development. My direct reference was a system known as CustusX,. The NCI used this system in their research of surgical navigation and it's application.

I was asked to create the UX for a surgical navigation system called Discovery. For those of you that don't know what surgical navigation is: It's a procedure in which a system matches the position of the digital surgical equipment in relation to the real position of the surgical equipment translated into a digital space (imagine an ultrasound sensor that you have in your hand digitized into an interface). This digital space then uses images to help guide the surgeon throughout their surgery.

The reason this is done is to help the surgeon perform the surgery with higher accuracy. It gives the surgeon an extra dimension of awareness while performing the surgery, and helps with minimizing the damage that a patient can sustain during surgery. During the surgery the surgeon is assisted by a technical physician, they help with the technical aspect of the surgical navigation.

The biggest challenge for me was adjusting to the medical world and reacting accordingly. During my time at the NCI I worked with a nice team that was quite welcoming and helpful. This certainly helped with getting adjusted into a very foreign field (to me).


Because the Discovery system was still in development I found creating a UX for it quite complex What was it exactly and how did it work? What is needed to create a strong interface for a system like this? To help the NCI with their further research of the system's design. I decided to create a design language why? It's scalable, flexible and if done right easily transferrable to new designers.

CustusX was a system that had specific issues. And to create a good version of the new system I first looked at what I would do different in the old system. The problems were:

  1. A high learning curve
  2. A clogged menu
  3. Complex error-handling
  4. Interface not user centered
These issues made way for communications problems and time that was lost (very important during surgery). This prompted me to research different types of systems, this way I could see how they handled these issues and what I could use as an inspiration.

To better understand the medical world and surgical navigation I interviewed multiple researchers of the NCI and a few of the users (surgeons and technical physicians) of the surgical navigation system. This helped with realising what the users themselves wanted and how they saw the system.

To help with creating a strong, intuitive interface I sat together with Matteo, Ruben and Jasper every week (also during the corona pandemic). During these weekly meetings we discussed different idea's I had and we looked at how applicable they were for this project. All of their feedback helped with forming the current iteration of the design I've created.


Implementation was a hard thing because it was quite impossible given the circumstances. So to replicate the implementation phase I created a prototype that users could test and look through. To ensure implementation I used the weekly meeting as a way to confirm the possibilities.

During these 4.5 months I've created a prototype and a design language these were the final products after researching, testing and discussing every step that was made. The rest of the implementation is a process that the NCI itself has to do.


Working in a completely foreign world by myself was interesting and scary at the same time. I didn't know what to expect and I wasn't sure how I would handle the project itself. But the team I worked with and my time there were both extremely pleasant. A lot of bright minds and people that were always ready to help.

I enjoyed my time at the NCI. The biggest regret I have is that I wasn't able to test the system more than I did. Due to the pandemic I wasn't able to sit as much with the target group as I hoped. This in turn makes me curious as to what issues will arise in the future perhaps the system is not ready to be used, but I think further testing would eliminate that issue.

I would love to get the chance to work with the NCI again, or atleast work on a complex problem like this one again. I like to challenge my skills as a designer and I was able to create a product that I was quite proud of during these 4.5 months, see the screens of the surgical navigation system called Discovery here.