Table 3.
Augmented reality applications in surgery
| Augmented reality application | Sample size | Purpose | Outcome |
|---|---|---|---|
| ProMIS Augmented Reality Laparoscopic Simulator (Haptica, Dublin, Ireland) | 55 | Laparoscopic skills | Realism considered good to excellent by all participants, mixed evaluations of didactic value27 |
| 18 | Suturing | Significant improvement in knot scores following training with the simulator29 | |
| 15 | Laparoscopic skills | Improvement in task completion with greater efficiency32 | |
| 46 | Laparoscopic skills | Significant correlation between experience and performance30 | |
| 24 | Suturing | Experienced participants had higher performance scores than novice participants28 | |
| 35 | Laparoscopic colectomy | Simulator model rated as easier than cadaver model26 | |
| 115 | Laparoscopic skills | Experience levels correlated strongly with simulation scores31 | |
| ImmersiveTouch System (ImmersiveTouch, Inc., University of Illinois, Chicago, IL, USA) | 16 | Ventriculostomy | AR group more likely to succeed on first attempt. Residents praised the simulator for its realism34 |
| 51 | Thoracic pedicle screw placement | Non-significant reduction of failure rate in screw placement33 | |
| ARToolKit (ARToolWorks Inc., Seattle, WA, USA) | 10 | Echocardiography | Trainees were able to successfully perform an ECG test59 |
| Vuzix 920AR goggles (Vuzix Corp., Rochester, NY, USA) | 21 | Tumor resection planning | Improved non-clinicians’ performance and significantly improved time to task completion for clinicians60 |
| System for Telementoring with Augmented Reality (STAR) [Purdue University, West Lafarette, IN, USA] | 20 | Surgical telementoring | Less placement errors and fewer focus shifts, but took more time for each task61 |
| Brother AiRScouter WD-200B AR glasses (Brother International Corp., Bridgewater, NJ, USA) | 32 | Central line insertion | No difference in median total procedure time between AR and control groups62 |
| EyeSi augmented reality binocular indirect ophthalmoscopy simulator (VYmagic Holding AG, Mannheim, Germany) | 28 | Binocular indirect ophthalmoscopy (BIO) | AR group demonstrated superior total scores and performance35 |
| 37 | BIO | More correct sketched vessels and higher Ophthalmoscopy Training Score for AR group36 | |
| Hand-on Surgical Training (HoST) urethrovesical anastomosis (UVA) AR module (Roswell Park Cancer Institute and the State University of New York at Buffalo Virtual Reality Laboratory, New York, NY, USA) | 52 | UVA | HoST group outperformed control group on multiple measures while having lower temporal demand and mental fatigue63 |
| Google Glass (Google Inc., Mountain View, CA, USA) | 30 | Inflatable penile prosthesis placement | 81% of participants recommended implementation of application into training program; 93% felt Google Glass has a place in the operating room64 |
| Unspecified prototype AR simulator | 60 | Ultrasound-guided needle placement | Majority positive responses for usability and training feasibility65 |
| Epson Moverio BT-200 Smart Glasses (Epson America, Inc., Long Beach, CA, USA) | 40 | Central line insertion | Participants reported that simulation was realistic, easy to use and useful for training; 59.3% responded that AR was better than other training methods66 |
| MicronTracker2 (Claron Technologies, Toronto, ON, Canada) | 10 | Spinal needle insertion | Overall positive responses to the system by trainees67 |
| Augmented reality telementoring (ART) platform (University of Nevada School of Medicine, Las Vegas, NV, USA) | 18 | Surgical telementoring | After training, ART group was faster and had fewer failed attempts68 |
| Microsoft Hololens (Microsoft Corp., Redmond, WA, USA) | 24 | Surgical telementoring | Mixed feedback on Hololens versus full telemedicine setup, no statistical difference in performance69 |
| Fundamentals of Laparoscopic Surgery (FLS) module (Society of American Gastrointestinal and Endoscopic Surgeons, Los Angeles, CA, USA) | 20 | Standard peg transfer | Participants preferred using the timed overlay over no feedback; no difference in time to task completion or muscle fatigue70 |