Projected Augmented Reality in Surgery: History, Validation, and Future Applications.

Area of Science:

• Medical technology
• Surgical innovation
• Computer-assisted surgery

Background:

• Projected Augmented Reality (PAR) provides a hands-free, universally visible surgical interface.
• PAR offers advantages over head-mounted displays, including improved collaboration and ergonomics.
• Integrating PAR with Artificial Intelligence (AI) can automate surgical planning and enhance guidance.

Purpose of the Study:

• To develop and validate a PAR platform for intraoperative projection of surgical and anatomic markings.
• To integrate AI for automated surgical landmark detection and marking design.
• To assess the precision and usability of the PAR system in a surgical context.

Main Methods:

• Developed a PAR system using structured light scanning and depth cameras for 3D anatomical reconstruction.
• Digitally created surgical markings and projected them onto anatomical models with a projector.
• Trained a machine learning model to detect cleft lip landmarks and automate surgical marking design.

Main Results:

• The PAR system achieved sub-millimeter precision in projecting both surgeon and AI-generated markings.
• Projections remained accurate and visible to the entire surgical team during movement.
• The system demonstrated clear visibility without requiring wearable hardware for users.

Conclusions:

• AI-integrated PAR delivers accurate, real-time, and shared intraoperative guidance.
• This technology enhances surgical precision and offers potential for remote mentorship and global surgical training.
• PAR represents a significant advancement in collaborative surgical interfaces.