Advancing laparoscopic surgery with the use of augmented reality headsets

Laparoscopic surgery faces ergonomic and visualization challenges. While robotic surgery addresses these challenges, it is often limited by cost. AR headset technology can offer a readily implementable complement to laparoscopic surgery at a lower cost. We aimed to evaluate the potential utility of implementing augmented reality (AR) glasses as an alternative to traditional laparoscopic display screens.

A within-subjects crossover study was conducted, including 34 participants consisting of urology residents, fellows, and staff. Participants completed either a circle cutting exercise in a laparoscopic box simulator (n=19) or a procedural step during a live porcine nephrectomy (n=15), using both the traditional laparoscopic display and AR glasses. Participants completed a questionnaire assessing the AR glasses in image quality, ergonomics, task performance, and overall experience.

The majority of ratings favored AR glasses over traditional monitors for image quality, ergonomics, and performance. Most participants favored AR glasses over traditional monitors, with 85.8% favoring AR for image quality (p<0.001), 84.8% for ergonomics (p<0.001), 90.1% for performance (p<0.001), and 90.1% for overall experience (p<0.001).

AR glasses are a feasible alternative to traditional laparoscopic displays, providing the benefits of improved ergonomics and visualization during laparoscopic surgery, while benefiting from substantially lower costs in comparison to robotic systems. These advantages and high overall participant satisfaction suggest that AR technology could serve a role in complementing and enhancing laparoscopic surgery. Validation in a real-world setting is imperative to corroborate these findings.