Apple Vision Pro as an augmentative tool in surgery: a double-edged scalpel

Benefits

The Apple Vision Pro’s advanced capabilities, including high-resolution displays, hand-tracking, and voice/gesture controls, make it a promising tool for surgical procedures. The device’s high-resolution displays and intuitive interface enable immersive visualization of patient-specific 3D anatomy. Its enhanced visualization capabilities provide surgeons with a more detailed and comprehensive view of the surgical site, potentially improving their ability to identify and address subtle anatomical features or anomalies. One report indicated that the quality of 3D models feels realistic, scoring 4.5/5 in a recent survey¹. This enhanced visualization can aid in preoperative planning and intraoperative navigation, potentially improving surgical outcomes. Additionally, the device’s video passthrough technology provides a natural view of the real-world environment, rated 4.3/5 by users, reducing the risk of disorientation during procedures¹.

By providing surgeons with an immersive, hands-free interface, Vision Pro can enhance visualization and access to critical real-time data, such as patient vital signs, imaging scans, and procedural guidelines. For novice surgeons, the Apple Vision Pro offers augmented reality overlays that can provide step-by-step surgical instructions and visual aids, thereby improving their confidence and competence in the operating room. This level of interactive guidance can play a pivotal role in training, reducing the learning curve for various surgical techniques.

The Apple Vision Pro allows for the first-person perspective recording and streaming of surgical procedures. This capability is invaluable for documenting intricate surgical details, which can be used for postoperative reviews, enhancing overall procedural accuracy, and maintaining comprehensive medical records. The device’s capacity for real-time remote collaboration is a significant advantage. Experienced surgeons can guide less seasoned surgeons through complex procedures, regardless of geographical limitations. This also extends to medical education, where live surgeries can be streamed to medical students and residents, offering them an immersive learning experience that bridges the gap between theoretical knowledge and practical application.

Innovative features such as eye tracking and gesture recognition enable surgeons to interact with the device seamlessly, reducing the need for physical touch interfaces that could compromise sterility. For surgeons who perform endoscopic procedures, the Apple Vision Pro eliminates the reliance on static monitors, significantly boosting operational agility². By facilitating optimal screen placement, the Vision Pro not only alleviates physical stress but also fosters unparalleled focus and precision during intricate surgical maneuvers. Moreover, the introduction of the Apple Vision Pro into the surgical environment can significantly reduce spatial constraints by eliminating cumbersome monitors and complex power cords, effectively decreasing potential safety hazards during surgical procedures and creating a cleaner, safer, and more efficient workspace for surgeons.

Currently, applications such as eXeX and myMako are beginning preliminary explorations with the Apple Vision Pro. The eXeX software was successfully utilized in spinal surgeries at Cromwell Hospital, where nurses used Vision Pro to access real-time surgical data, aiding in preparation, progress tracking, and instrument selection, resulting in reduced human errors and increased surgical confidence³. Similarly, Stryker’s myMako app allows surgeons to review surgical plans for joint replacements in a 3D-native, intuitive manner, potentially transforming preoperative planning and intraoperative experiences⁴. These preliminary findings suggest that combining Apple Vision Pro with specialized medical software can improve surgical efficiency, accuracy, and outcomes, warranting further large-scale clinical trials to fully assess its long-term impact and explore broader applications in the medical field.

Challenges

The high cost of the Apple Vision Pro ($3499) may limit its widespread adoption⁵. If each member of the surgical team needs to wear the device for coordinated work, the overall cost will escalate further. The prohibitive pricing structure of the Apple Vision Pro may inadvertently create a technological divide within the healthcare sector. High-resource institutions may be able to leverage these advanced tools, potentially leading to improved surgical outcomes and patient care. Conversely, lower-resource facilities may be unable to access these technologies, potentially resulting in a widening gap in the quality of care provided. This disparity in access to innovative surgical technologies could have far-reaching implications for healthcare equity. It may contribute to geographical variations in the standard of care, with advanced surgical techniques becoming concentrated in well-funded urban centers, while rural or underfunded healthcare facilities lag behind.

Additionally, the adoption of Apple Vision Pro in surgical settings is not without challenges. Despite its many advantages, the first-person view may introduce blind spots, potentially leading to contamination during surgery. Ensuring a comprehensive visual field remains unobstructed is crucial for maintaining sterile conditions and preventing surgical site infections. While the promise of remote collaboration is considerable, there are inherent challenges in synchronizing the inputs and actions of multiple surgeons. Differences in perspectives, latency in communication, and varying degrees of comfort with the technology can impede seamless collaboration, potentially affecting the outcome of the surgery.

The device’s current battery life of 2–2.5 h may be insufficient for longer procedures, necessitating external power solutions⁶. Additionally, comfort remains a concern. The weight of the Apple Vision Pro ranges from 600 to 650 g⁶, depending on the configuration of the light seal and headband. Users rated the headset’s comfort at 3.7/5¹. Extended use of Apple Vision Pro in lengthy surgical procedures may lead to physical and cognitive fatigue. Prolonged periods of wearing the device could strain the surgeon’s eyes and neck, potentially diminishing their overall effectiveness and precision. While the device did not induce significant eye strain or cybersickness in initial trials, the effects of prolonged use in high-stress surgical environments require further investigation. There are also concerns regarding the learning curve associated with integrating this new technology into established surgical workflows. Comprehensive training programs will be necessary to ensure that surgical teams can effectively utilize the device without compromising patient safety or procedural efficiency. Additionally, concerns regarding data privacy and security must be addressed to ensure patient information remains confidential.

Outlook

The Apple Vision Pro demonstrates significant potential in enhancing surgical procedures across various specialties. Its successful integration into routine clinical practice will require ongoing collaboration between technology developers, medical professionals, and healthcare institutions. Comparative studies with other AR solutions in surgery are necessary to provide valuable insights for healthcare institutions considering adoption. Furthermore, the potential integration of AI-driven assistance features within Apple Vision Pro could further enhance surgical outcomes by providing real-time feedback and guidance. While challenges remain, the technology shows promise in transforming surgical practices, potentially leading to improved patient care and outcomes. Continued research and development will be crucial to fully realize the benefits of this innovative technology in the medical field.

Ethical approval

Informed consent was not required for this editorial.

Consent

Informed consent was not required for this editorial.

Source of funding

None.

Author contribution

C.L.: study concept or design, data collection, data analysis or interpretation, and writing the paper.

Conflicts of interest disclosure

The author declares no conflicts of interest.

Research registration unique identifying number (UIN)

Not applicable.

Guarantor

Cheng Li.

Data availability statement

Not applicable.

Provenance and peer review

Not commissioned, externally peer-reviewed.

Assistance with the study

None.