Extended Reality in Laparoscopic Cholecystectomy Training: A Systematic Review and Meta-analysis.

Area of Science:

• Surgical Technology
• Medical Simulation
• Minimally Invasive Surgery

Background:

• Extended reality (XR) augmentation is a novel approach to enhance surgical procedures.
• Laparoscopic cholecystectomy is a common surgical intervention where precision is critical.
• Evaluating XR's impact on surgical performance is essential for its clinical adoption.

Purpose of the Study:

• To systematically review and meta-analyze the effect of XR augmentation on surgical precision and performance.
• To assess the pooled impact of XR on laparoscopic cholecystectomy outcomes.
• To synthesize evidence on XR's utility in enhancing surgical skills.

Main Methods:

• Systematic review and meta-analysis adhering to PRISMA guidelines.
• Searched MEDLINE, Scopus, Google Scholar, and Cochrane Library for trials (2019-2023).
• Included four unique randomized controlled trials with 158 surgeons; assessed risk of bias using Cochrane Risk of Bias 2 tool.

Main Results:

• XR-assisted surgery significantly improved Global Objective Structured Assessments of Technical Skills (OSATS) scores (MD, 2.07; 95% CI, 0.34-3.80).
• XR augmentation led to significant improvements in Global Operative Assessment of Laparoscopic Skills (GOALS) scores (MD, 1.53; 95% CI, 0.48-2.57).
• Task-specific OSATS and GOALS scores also demonstrated significant improvements with XR use.

Conclusions:

• XR augmentation demonstrably enhances surgical performance and precision during laparoscopic cholecystectomy.
• Findings suggest XR is a valuable tool for improving surgical skills.
• Larger, rigorous studies are recommended to confirm generalizability and define XR's role in surgical training.