J reconstr Microsurg
DOI: 10.1055/s-0039-3401832
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Use of Augmented Reality in Reconstructive Microsurgery: A Systematic Review and Development of the Augmented Reality Microsurgery Score

Yasser Al Omran
1  Department of Plastic Surgery, Birmingham Women's and Children's Hospital NHS Foundation Trust, Birmingham Children's Hospital Steelhouse Lane, Birmingham, United Kingdom
,
Ali Abdall-Razak
2  Imperial College School of Medicine, London, United Kingdom
,
3  Academic Plastic Surgery Group, Barts and The London School of Medicine and Dentistry, London, United Kingdom
,
Tiffanie-Marie Borg
3  Academic Plastic Surgery Group, Barts and The London School of Medicine and Dentistry, London, United Kingdom
,
Hayat Nadama
4  University of Nottingham School of Medicine, Nottingham, United Kingdom
,
Nader Ghassemi
5  Department of Surgery, University Hospital North Midlands NHS Foundation Trust, Stoke-on-Trent, Staffordshire, United Kingdom
,
Khine Oo
6  Keele University School of Medicine, Keele, Staffordshire, United Kingdom
,
Ali M. Ghanem
3  Academic Plastic Surgery Group, Barts and The London School of Medicine and Dentistry, London, United Kingdom
› Author Affiliations
Funding None.
Further Information

Publication History

19 July 2019

28 October 2019

Publication Date:
19 December 2019 (online)

Abstract

Introduction Augmented reality (AR) uses a set of technologies that overlays digital information into the real world, giving the user access to both digital and real-world environments in congruity. AR may be specifically fruitful in reconstructive microsurgery due to the dynamic nature of surgeries performed and the small structures encountered in these operations. The aim of this study was to conduct a high-quality preferred reporting items for systematic reviews and meta-analyses (PRISMA) and assessment of multiple systematic reviews 2 (AMSTAR 2) compliant systematic review evaluating the use of AR in reconstructive microsurgery.

Methods A systematic literature search of Medline, EMBASE, and Web of Science databases was performed using appropriate search terms to identify all applications of AR in reconstructive microsurgery from inception to December 2018. Articles that did not meet the objectives of the study were excluded. A qualitative synthesis was performed of those articles that met the inclusion criteria.

Results A total of 686 articles were identified from title and abstract review. Five studies met the inclusion criteria. Three of the studies used head-mounted displays, one study used a display monitor, and one study demonstrated AR using spatial navigation technology. The augmented reality microsurgery score was developed and applied to each of the AR technologies and scores ranged from 8 to 12.

Conclusion Although higher quality studies reviewing the use of AR in reconstructive microsurgery is needed, the feasibility of AR in reconstructive microsurgery has been demonstrated across different subspecialties of plastic surgery. AR applications, that are reproducible, user-friendly, and have clear benefit to the surgeon and patient, have the greatest potential utility. Further research is required to validate its use and overcome the barriers to its implementation.