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Updated: May 9, 2026

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Augmented Reality in Navigated Surgery: A Systematic Review of Clinical Accuracy and System Performance.

Noa Nicolai1, Sander J C Tabernée Heijtmeijer2,3, Mohamed Benmahdjoub4,5

  • 13D Lab, University Medical Center Utrecht, Netherlands.

Mayo Clinic Proceedings. Digital Health
|May 8, 2026
PubMed
Summary

Augmented reality (AR) navigation shows promise in surgery, potentially reducing radiation exposure. However, current clinical evidence is limited, and implementation faces technical and usability challenges.

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Area of Science:

  • Medical Technology
  • Surgical Navigation
  • Augmented Reality

Background:

  • Augmented reality (AR) and mixed reality (MR) systems are increasingly explored for surgical navigation.
  • Clinical implementation requires robust data on accuracy, usability, and practical barriers.

Purpose of the Study:

  • To systematically evaluate the clinical application of AR navigation systems.
  • Focus on accuracy, usability, and factors affecting clinical integration.

Main Methods:

  • Systematic literature search (Embase, PubMed, Scopus, Web of Science) from 2018 to 2025.
  • Inclusion of clinical studies involving patients.
  • Data extraction on system type, accuracy, usability, and implementation factors.

Main Results:

  • 61 studies included, spanning various surgical specialties like oral/maxillofacial, neurosurgery, spinal, and orthopedics.
  • Variable accuracy reported; potential for reduced radiation exposure and operative time.
  • Usability assessment often qualitative; common limitations include accuracy, ergonomics, and workflow integration.
  • Evidence quality generally low to very low.

Conclusions:

  • AR navigation shows potential but is supported by low-certainty evidence.
  • Clinical integration is hampered by technical, ergonomic, and workflow barriers.
  • Future research needs rigorous methodology to improve accuracy and usability evaluation.