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Review
. 2023 Jan 6:11:e41297.
doi: 10.2196/41297.

Mixed Reality in Modern Surgical and Interventional Practice: Narrative Review of the Literature

Mats T Vervoorn #  1 , Maaike Wulfse #  1 , Tristan P C Van Doormaal  1   2 , Jelle P Ruurda  1 , Niels P Van der Kaaij  1 , Linda M De Heer  1
Affiliations
Review

Mixed Reality in Modern Surgical and Interventional Practice: Narrative Review of the Literature

Mats T Vervoorn et al. JMIR Serious Games. .

Abstract

Background: Mixed reality (MR) and its potential applications have gained increasing interest within the medical community over the recent years. The ability to integrate virtual objects into a real-world environment within a single video-see-through display is a topic that sparks imagination. Given these characteristics, MR could facilitate preoperative and preinterventional planning, provide intraoperative and intrainterventional guidance, and aid in education and training, thereby improving the skills and merits of surgeons and residents alike.

Objective: In this narrative review, we provide a broad overview of the different applications of MR within the entire spectrum of surgical and interventional practice and elucidate on potential future directions.

Methods: A targeted literature search within the PubMed, Embase, and Cochrane databases was performed regarding the application of MR within surgical and interventional practice. Studies were included if they met the criteria for technological readiness level 5, and as such, had to be validated in a relevant environment.

Results: A total of 57 studies were included and divided into studies regarding preoperative and interventional planning, intraoperative and interventional guidance, as well as training and education.

Conclusions: The overall experience with MR is positive. The main benefits of MR seem to be related to improved efficiency. Limitations primarily seem to be related to constraints associated with head-mounted display. Future directions should be aimed at improving head-mounted display technology as well as incorporation of MR within surgical microscopes, robots, and design of trials to prove superiority.

Keywords: education; extended reality; intervention; mixed reality; surgery.

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Conflict of interest statement

Conflicts of Interest: TPCVD is the founder and current Chief Medical Officer of Augmedit B.V., Naarden, The Netherlands.

Figures

Figure 1
Figure 1
Graphical depiction of the differences between virtual, augmented, and mixed reality.
Figure 2
Figure 2
Flowchart of the conducted search on mixed reality in surgical and interventional practice.
See this image and copyright information in PMC

References

    1. Han J, Kang H, Kim M, Kwon GH. Mapping the intellectual structure of research on surgery with mixed reality: bibliometric network analysis (2000-2019) J Biomed Inform. 2020 Sep;109:103516. doi: 10.1016/j.jbi.2020.103516. https://linkinghub.elsevier.com/retrieve/pii/S1532-0464(20)30144-1 S1532-0464(20)30144-1 - DOI - PubMed
    1. Yeung AWK, Tosevska A, Klager E, Eibensteiner F, Laxar D, Stoyanov J, Glisic M, Zeiner S, Kulnik ST, Crutzen R, Kimberger O, Kletecka-Pulker M, Atanasov AG, Willschke H. Virtual and augmented reality applications in medicine: analysis of the scientific literature. J Med Internet Res. 2021 Feb 10;23(2):e25499. doi: 10.2196/25499. https://www.jmir.org/2021/2/e25499/ v23i2e25499 - DOI - PMC - PubMed
    1. Milgram P, Kishino F. A taxonomy of mixed reality visual displays. IEICE Transactions on Information Systems. 1994. Dec 1, [2021-12-05]. https://cs.gmu.edu/~zduric/cs499/Readings/r76JBo-Milgram_IEICE_1994.pdf .
    1. Skarbez R, Smith M, Whitton MC. Revisiting Milgram and Kishino's reality-virtuality continuum. Front Virtual Real. 2021 Mar 24;2 doi: 10.3389/frvir.2021.647997. - DOI
    1. Gehrsitz P, Rompel O, Schöber M, Cesnjevar R, Purbojo A, Uder M, Dittrich S, Alkassar M. Cinematic rendering in mixed-reality holograms: a new 3D preoperative planning tool in pediatric heart surgery. Front Cardiovasc Med. 2021 Feb 9;8:633611. doi: 10.3389/fcvm.2021.633611. https://europepmc.org/abstract/MED/33634174 - DOI - PMC - PubMed