The use of augmented reality in transsphenoidal surgery: A systematic review

Use of Neuronavigation and Augmented Reality in Transsphenoidal Pituitary Adenoma Surgery

“…In this study, no significant difference in surgical time (incision to suture) is seen in both groups, whereas preparation time (beginning to patient positioning to incision) in one group including the additional requirement of patient registration differed significantly, the same accounts for overall time incorporating patient preparation and surgical time. However, in line with [ 22 ], prolonged time might be more dependent on the familiarity of the whole team (OR staff, technical staff, anesthesia team, and surgeons) with the technology, even though a mean additional time in the pre-surgical phase for patient registration of roughly twelve minutes as in this study seems reasonable. Nevertheless, further studies are needed to evaluate the effect of AR support on pre- and intraoperative time.…”

“…The use of AR support and thereof navigation support might require additional preoperative and intraoperative procedural time. However, studies on the extent and significance of time reduction/time increase are rare [ 22 ]. As also in the classical approach a thorough planning of the surgical procedure is highly recommended [ 23 ] also preoperative segmentation is somehow time-consuming.…”

“…Due to the retrospective analysis in this study, preoperative planning time was not acquired in all cases, but given the diverse planning tool offered by the used navigation system, preoperative planning of transsphenoidal procedures outlining the lesion and vascular and neural risk structures is available in a moderate amount of time, depending on image quality and clinical and technical user experience. For overall operative time, mixed effects are seen [ 22 ]. Most set-ups analyzed in a recent review include different platforms, microscope-based or endoscope-based AR systems, and differing definitions of “used time” (e.g., overall and surgical) making results hard to interpret.…”

“…Supported by lateral fluoroscopy and identification of key landmark structures, this allowed for fast and easy orientation making the transsphenoidal approach a somewhat straightforward procedure. However, due to the limited line of sight, surgical orientation can especially be difficult in case of anatomical variants such as reduced intercarotid artery distance that is more frequently seen in patients with acromegaly [ 19 , 20 ], anatomic variation of the sphenoid sinus [ 21 ], or previous transsphenoidal surgery (adhesion, fibrosis, and obscured/distorted/missing surgical landmarks) [ 21 , 22 ]. As recently reported, there is also a high inconsistency and wide variation of anatomical landmarks; it is important to bear this inconsistency in mind when relying only on anatomical landmarks and also to comprehensively plan the procedure before surgery [ 23 ].…”

State of the Art and Future Prospects of Virtual and Augmented Reality in Veterinary Medicine: A Systematic Review

“…The use of VR/AR is not limited to the gaming and entertainment industries—different types of VR or AR can be used in different fields, such as in education [ 11 , 12 ], military and sports training [ 13 ], architectural projects [ 14 ], etc. In human medicine, the use of AR/VR has also increased during the past decade, and different studies have investigated the effectiveness of these methods in different medical specialties, such as neurosurgery [ 15 , 16 , 17 , 18 , 19 , 20 , 21 ], surgery [ 22 , 23 , 24 ], ophthalmology [ 6 , 25 ], orthopedics [ 26 , 27 ], physical medicine and rehabilitation [ 28 , 29 ], urology [ 30 ], etc. However, despite advances in human medicine, VR/AR has been overlooked in the veterinary field; therefore, there is great capacity in veterinary medicine to use these technologies for educational, diagnostic, and therapeutic purposes.…”