The invention is directed to a methodology (and corresponding system) that utilizes an imaging device that generates images of target tissue of a patient during a surgical procedure that acts on the target tissue imaged by the imaging device. The methodology enables an operator to visually detect patient movement during the surgical procedure by initially interacting with the operator to mark at least one spatial attribute of one or more common and easily identifiable features of the target tissue illustrated in an image presented in a display window. Prior to acting on the target tissue, a visual indicator of the operator-inputted spatial attribute(s) is superimposed on one or more subsequent images captured by the imaging device and displayed to the operator. The operator can visually compare position of the visual indicator to position of the operator-identified feature in order to detect movement of the patient during the procedure. The system and methodology also facilitates realignment that corrects for detected patient movement.