Broderick Ryan C, Spurzem Graham J, Jeffery Reeves J, Hollandsworth Hannah M, Sandler Bryan J, Jacobsen Garth R, Longhurst Christopher A, Horgan Santiago
Division of Minimally Invasive Surgery, Department of Surgery, Center for the Future of Surgery, University of California San Diego, 9300 Campus Point Dr. La Jolla, San Diego, CA, 92037, USA.
Joan & Irwin Jacobs Center for Health Innovation, University of California San Diego, San Diego, CA, USA.
Surg Endosc. 2025 Jul 10. doi: 10.1007/s00464-025-11985-x.
BACKGROUND: Augmented reality (AR) is an evolving technology with the potential to transform surgical practice. By superimposing digital information onto the surgeon's field of view, AR headsets provide an unobstructed view of the minimally invasive operative field, eliminating the need to divert attention to external monitors. We present the first series of minimally invasive general surgery (MIS) cases performed using the Apple Vision Pro headset in the USA. METHODS: Attending surgeons and trainees performed consecutive MIS cases at our institution while wearing the headset from August 2024 to December 2024. Using open-source software, laparoscopic/endoscopic video sources were displayed as virtual monitors in the physical operating room space. The virtual monitors served as the primary monitors through which surgeons performed each case. Standard monitors remained present to enable other members of the operative team to view the operations. At the conclusion of each case, the operating surgeon completed the NASA Task Load Index (NASA-TLX) assessment tool to evaluate perceived workload while operating with the headset. 30-day perioperative complications were also assessed. RESULTS: A total of 41 MIS cases were performed by 3 attending surgeons and 4 trainees. The most common procedure was laparoscopic sleeve gastrectomy (N = 9, 22.0%). Open-source software enabled simultaneous viewing of up to 3 virtual displays that could be individually positioned in the surgeon's visual field. The mean NASA-TLX score for all participants was 22.3 ± 4.7, indicating a low perceived intraoperative workload. There was no significant difference in NASA-TLX scores between attending surgeons and trainees (19.8 ± 5.3 vs 24.8 ± 3.0, p = .23). There were no intraoperative complications; 30-day morbidity and mortality were 0%. CONCLUSION: This study serves as a proof of concept for the use of an augmented reality headset in minimally invasive general surgery.
背景:增强现实(AR)是一项不断发展的技术,具有改变外科手术实践的潜力。通过将数字信息叠加到外科医生的视野上,AR头显提供了微创术野的无阻碍视野,无需将注意力转移到外部监视器上。我们展示了美国首例使用苹果Vision Pro头显进行的微创普通外科(MIS)病例系列。 方法:2024年8月至2024年12月期间,主治外科医生和实习生在我们机构佩戴头显进行连续的MIS病例。使用开源软件,腹腔镜/内镜视频源在物理手术室空间中显示为虚拟监视器。虚拟监视器作为外科医生进行每个病例操作的主要监视器。标准监视器仍然保留,以便手术团队的其他成员观看手术。每个病例结束时,主刀医生完成NASA任务负荷指数(NASA-TLX)评估工具,以评估使用头显操作时的感知工作量。还评估了30天围手术期并发症。 结果:3名主治外科医生和4名实习生共进行了41例MIS病例。最常见的手术是腹腔镜袖状胃切除术(N = 9,22.0%)。开源软件能够同时查看多达3个虚拟显示器,这些显示器可以分别定位在外科医生的视野中。所有参与者的平均NASA-TLX评分为22.3±4.7,表明术中感知工作量较低。主治外科医生和实习生之间的NASA-TLX评分没有显著差异(19.8±5.3对24.8±3.0,p = 0.23)。没有术中并发症;30天发病率和死亡率为0%。 结论:本研究为在微创普通外科中使用增强现实头显提供了概念验证。
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