Extended reality in surgery – past, present, and future

Abstract

Extended reality (XR) technology, encompassing virtual reality (VR), augmented reality (AR), and mixed reality (MR), has evolved significantly in its application to surgery. Initially limited by technical constraints, XR has progressed from basic VR applications in the 1990s to more sophisticated MR systems today. Current applications include advanced surgical training, detailed preoperative planning, intraoperative guidance, and remote surgical assistance. XR offers unique advantages in surgical education, allowing trainees to develop muscle memory while interacting with 3D anatomical models. In surgical planning and navigation, it enables surgeons to visualize complex 3D anatomies directly, potentially improving precision and reducing complications. Remote surgical assistance through XR platforms has shown promise in addressing healthcare disparities. However, the integration of XR in surgery faces several challenges. These include hardware limitations like image resolution and device comfort, software complexities, computing power constraints, and wireless communication issues. Data privacy and security concerns are significant, especially when handling sensitive patient information. Clinical validation remains a hurdle, with a need for standardized evaluation metrics and large-scale trials. User acceptance is also critical, as surgeons must adapt to new technologies and overcome potential resistance to change.