A review of head-mounted devices for surgical education, preoperative planning and intraoperative navigation

Head-Mounted Devices (HMDs) are wearable display systems that present immersive 3D virtual information directly in the user's line of sight. The review investigates the role and effectiveness of HMDs utilizing Mixed Reality (MR), Augmented Reality (AR), and Virtual Reality (VR) technologies in surgical education, preoperative planning, and intraoperative navigation, and identifies existing barriers to their broader adoption within the domain of surgical training and practice.​ A systematic literature search following PRISMA guidelines was performed, focusing on studies covering Virtual, Augmented, or Mixed Reality applications in surgical education, navigation, and planning. The search yielded 4783 studies published between 2019 and 2025; out of these, 33 were selected for detailed review based on predetermined inclusion criteria.​ Most included studies emphasized simulation-driven training protocols (27%) and modules for preoperative surgical planning (42%), with only a minority addressing intraoperative navigation systems (18%). Other studies (12%) were related to Marker-less image registration and usage of HMDs in bedside teaching during Covid. Typical limitations were small participant sizes, non-standardized outcome measures, and a lack of unified assessment frameworks. Reported benefits of HMD platforms included enhanced immersion, improved spatial orientation, procedural accuracy, and replication of surgical scenarios, exceeding the value of traditional approaches.​ HMD-based platforms provide significant advantages in surgical education and practice, facilitating superior simulation experiences, preoperative planning, and intraoperative navigation. Despite these advances, broader usage is limited by the absence of standardized evaluation tools, heterogeneous outcomes, and validation across larger, diverse cohorts. Future research should prioritize multicentric validation, curricular integration, and development of objective assessment tools.