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3D Head-Up Display Exoscope: An Ergonomic and Portable Alternative for Microsurgery.
Hyung Bae Kim1, So Min Oh1, Jin Sup Eom1
1From the Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine.
Plastic and Reconstructive Surgery
|November 17, 2025
Summary
The 3D head-up display (HUD) exoscope offers comparable surgical outcomes to traditional microscopes in breast reconstruction. This novel system enhances surgeon ergonomics and team visualization, presenting a viable alternative for microsurgical procedures.
Area of Science:
- Microsurgery
- Surgical Technology
- Plastic and Reconstructive Surgery
Background:
- Conventional surgical microscopes require rigid eyepiece alignment, potentially causing ergonomic strain for microsurgeons.
- Novel visualization systems are being developed to improve surgeon comfort and workflow in complex procedures.
Purpose of the Study:
- To compare the feasibility and outcomes of microsurgical breast reconstruction using a 3D head-up display (HUD) exoscope versus a conventional surgical microscope.
- To evaluate the ergonomic and workflow advantages of the 3D HUD exoscope.
Main Methods:
- A retrospective review of 34 patients (37 flaps) undergoing free flap breast reconstruction.
- Comparison of outcomes between 18 patients (21 flaps) treated with the 3D HUD exoscope and 16 patients (16 flaps) treated with a conventional microscope.
- Analysis of demographics, operative parameters, and patient outcomes.
Main Results:
- Mean microanastomosis time was similar between the 3D HUD exoscope and microscope groups (28.0 ± 4.1 min vs. 26.5 ± 11.7 min, p = 0.60).
- All flaps survived; one flap in the 3D HUD group experienced venous congestion requiring intervention (4.8%), with no significant difference in revisional surgery rates.
- The 3D HUD exoscope demonstrated enhanced ergonomic positioning and mitigated operator strain.
Conclusions:
- The 3D HUD exoscope is a viable alternative for microsurgical breast reconstruction, offering comparable surgical performance to traditional microscopes.
- The system provides significant advantages in surgeon comfort, team visualization, and setup efficiency.
- Potential applications include supermicrosurgery, telemicrosurgery, and robotic-assisted procedures.
