Virtual Reality and Surgical Performance in Operating Room in All Domains: A Systematic Review and Meta-Analysis

Virtual Reality (VR) technology has gained significant attention in surgical education and training. This systematic review and meta-analysis aim to evaluate the impact of VR on intraoperative surgical performance across various domains in the operating room (OR).

A comprehensive search of electronic databases (PubMed, MEDLINE, Cochrane Library Central Register of Controlled Trials, and Web of Science) was conducted to identify relevant studies published from 2010 to 2024. All the randomized controlled studies that assessed the effect of VR training on surgical performance in the OR were included in the study. The risk of bias was assessed using the Cochrane Collaboration's tool, evaluating domains such as random sequence generation, allocation concealment, and blinding. The inverse variance method was used to calculate the pooled mean difference for continuous outcomes, and a random-effects model was applied to account for heterogeneity.

The literature search identified 1284 potential articles, of which 11 studies met the inclusion criteria for quantitative synthesis. The meta-analysis revealed a significant positive effect of VR training on surgical outcomes, despite substantial heterogeneity (I ² = 95%). Eight of the eleven studies demonstrated that VR training significantly improved surgical performance, with mean differences ranging from 1.30 to 14.00 compared to the control group. Notably, two studies reported substantial positive effects with mean differences of 9.30 and 14.00, indicating marked enhancements in surgical skills. Conversely, no significant improvement in surgical performance was observed in three studies, which reported mean differences of 0.13 and -0.90 between the two groups.

VR training in the OR enhances surgical performance, reduces operative times, and potentially improves patient outcomes. The study supports the integration of VR into surgical education and training programs. Further research with larger sample sizes and long-term follow-up is warranted to confirm these benefits and explore the cost-effectiveness of VR training in surgery.

The online version contains supplementary material available at 10.1007/s12663-025-02449-9.