Virtual simulators with realistic graphics and force feedback have been developed for ventriculostomy, intraventricular surgery, and transsphenoidal pituitary surgery, thus allowing preoperative study of the individual anatomy and increasing the safety of the procedure. The authors also present experiences with their own virtual simulation of endoscopic third ventriculostomy.

ed to support enhanced digital visualizations for training and surgical planning using mixed reality (MR), virtual reality (VR), and augmented reality (AR). These extended reality technologies have been safely used to explore the operative field from different viewpoints, visualizing the neurovascular anatomy hidden from the surgical field, thereby offering an enhanced comprehensive sensory experience, especially in keyhole approaches to deep-lying targets. 1,2 Together with the fusion of additional imaging data such as indocyanine green (ICG), 5-aminolevulinic acid (5-ALA), or fluorescein angiography, MR has increased the precision in neurosurgical procedures. With work hour limitations and erstwhile COVID-19 restrictions, these technological advances also offer exemplary training and practicing tools for both novices and experts alike, resulting in their recent exponential growth. In addition, MR can be utilized for telecasting, patient education, and long-distance telecollaboration, and it can help bridge the global educational gap in the field of neurosurgery, including the scope of credentialing and recertifications. [3][4][5][6] Virtual RealityBased on the level of immersion, VR can be classified into non-immersive, semi-immersive, and fully immersive VR. With non-immersive VR, the virtual environment is viewed through a window on a standard monitor. Keyboard, mouse, or enhanced 3D interaction devices are used to interact with non-immersive VR. Semi-immersive VR combines high-performing graphics with a large screen projector, or multiple display projections, to widen the field of view and provide the user with an enhanced