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Extended reality for mapping perforator-based flaps in breast reconstruction: a systematic review and meta-analysis
Hester Lacey1,2, Anas Khan1, Baljit Dheansa2
1University Hospitals Sussex NHS Foundation Trust, Eastern Rd, Brighton and Hove, Brighton, BN2 5BE, UK.
JPRAS Open
|April 18, 2025
Summary
Extended reality (XR) technologies like augmented reality (AR) and virtual reality (VR) show limited accuracy in perforator identification for breast reconstruction. However, AR and VR may reduce operative and flap harvesting times.
Area of Science:
- Surgical Innovation
- Medical Imaging
- Reconstructive Surgery
Background:
- Extended reality (XR) technologies, including augmented reality (AR) and virtual reality (VR), offer potential applications in surgical planning and visualization.
- Their specific role in perforator-based breast reconstruction remains an area of active investigation.
Purpose of the Study:
- To systematically review and ascertain the role of extended reality (AR and VR) in perforator-based breast reconstruction.
Main Methods:
- A systematic literature search was conducted.
- Screening of identified articles was performed independently by two reviewers.
- Data extraction and analysis followed established systematic review protocols.
Main Results:
- Ten studies comprising 229 flaps were included.
- AR and VR showed varying accuracy in perforator localization (4 mm and 14 mm from intraoperative location, respectively).
- Significant reductions in flap harvesting time were reported for AR (19 min) and VR (88 min); VR also reduced operative time compared to Doppler ultrasound.
Conclusions:
- AR and VR offer limited improvements in perforator identification accuracy but may decrease operative and flap harvesting times.
- Key limitations include study heterogeneity and quality, necessitating larger sample sizes and higher-quality evidence for definitive conclusions.
- Further research is required to establish the definitive benefits and longitudinal outcomes of XR in perforator-based breast reconstruction.
