The intraoperative use of augmented and mixed reality technology to improve surgical outcomes: A systematic review

Abstract

Background This systematic review aims to critically appraise the intraoperative use of augmented and mixed reality technology to improve surgical outcomes. Method A literature search of PubMed, Scopus, Cochrane Central Register of Controlled Trials, http://ClinicalTrials.gov and WHO ICTRP was performed in accordance with Cochrane Handbook for Systematic Reviews of Interventions. Results This review included 94 studies on 2473 patients, comprising 78 studies on augmented reality and 16 on mixed reality. This technology has seen broad intraoperative application. Augmented and mixed reality can reduce operative duration, blood loss, and the duration of inpatient care. Current evidence shows that they achieve this most in percutaneous surgery. Conclusions Augmented and mixed reality technology improve surgical outcomes by increasing navigational speed and reducing navigational error intraoperatively. However, they have technical limitations which are the subject of ongoing research. Further studies are necessary to define how this technology is best applied intraoperatively. Systematic Review Registration: PROSPERO CRD42020205892.

Application of Extended Reality (Virtual Reality and Mixed Reality) Technology in Laparoscopic Liver Resections

“…Both technologies have made remarkable progress and are used not only in video games but also in everyday life, including industries such as construction and manufacturing. Reports of the application of VR are gradually increasing in medicine [13,14]. However, there are few studies on the application of VR and MR in LLR [15,16].…”

“…Additional research and development are needed to optimize the application of this technology and explore its full potential. Although there have been indications of its usefulness, the number of studies are few [10][11][12][13][14]. Previous studies have shown that the combination of XR technology with laparoscopic cholecystectomy performed by mid-career surgeons contributed to a decrease in blood loss and complication rates [19].…”

Experimental Setup for Evaluating Depth Sensors in Augmented Reality Technologies Used in Medical Devices

“…Despite these challenges, a growing number of AR applications have been used in training, education, telemedicine, preoperative planning and postoperative assessment, and intraoperative systems. [4,5]. For instance, AR HMDs enable capturing of images and videos from a surgeon's perspective and share them with remote users [6].…”

Experimental Setup for Evaluating Depth Sensors in Augmented Reality Technologies Used in Medical Devices

“…The challenges include integrating AR technology seamlessly into clinical workflows, ensuring patient safety and privacy, and overcoming technical limitations such as accuracy and field of view [ 5 , 6 ]. Despite these challenges, a growing number of AR applications have been used in training, education, telemedicine, preoperative planning and postoperative assessment, and intraoperative systems [ 7 , 8 ]. For instance, AR HMDs enable capturing of images and videos from a surgeon’s perspective and share them with remote users [ 9 ].…”