Category: Endoscopic

MP21-3 - Evaluating the Effectiveness of the Microsoft HoloLens as an Endoscopic Monitor and Imaging Tool: The Future of Endoscopic Surgery?

Sat, Sep 22
2:00 PM - 4:00 PM

Introduction & Objective :

The advent of Augmented and Mixed Reality technologies presents new opportunities for enhancing current surgical practices. Endourological surgery has been an integral part of urology since the late 1970s. Studies suggest that current techniques are prone to disturbance of a surgeon’s visual-motor axis, influencing operative performance, ergonomics and iatrogenic injury rates. The Microsoft HoloLens (HL) is a novel mixed reality head mounted display, that has not been thoroughly explored within surgical innovation research. This study evaluates the HL as a potential alternative to conventional monitors in endourological surgery.

Methods :

60 study participants of varying expertise in urology were grouped into three groups: novices (n=29), intermediates (n=15), and experts (n=16), and received training on operating the HL. Participants performed semi-rigid ureteroscopies on a previously validated urological simulator in a full immersion environment using both the HL and conventional monitors. Primary outcome measures were procedural completion times and Overall Satisfaction (OSAT) scores. A final comprehensive evaluation survey concerning the HL was distributed and completed for analysis.

Results :

Procedural time in seconds (mean ± SD) was significantly shorter using the HL compared to conventional monitors, irrespective of expertise level (258 ± 53.8 vs 330.5 ± 133.6, p=0.0011). OSAT scores were higher with the HL compared to standard monitors (21.40 ± 2.42 vs 17.31 ± 3.23, p<0.0001). Higher participant expertise correlated with shorter procedural times (p<0.0001) and higher OSAT scores (p<0.0001). More than 95% of participants agreed or strongly agreed that the HL has a potential role within surgical practice and is feasible to introduce clinically (Mean: 4.4/5).

Conclusions :

The HL is a potential and feasible alternative to conventional endoscopic monitors. Our study demonstrates that the device facilitated improved outcomes of performance and was widely accepted as a surgical visual aid by the study participants. This may be due to the HL being ergonomically advantageous by aligning the surgeon’s visual-motor axis, however it should be explored further in longer operations. The HL can also be a useful imaging tool, particularly when used with live fluoroscopy feeds and dynamic CT scans in more complex procedures.

Hasaneen F. Al Janabi

Medical Student
MRC Centre for transplantation, Guy’s Hospital, King’s College London, UK
London, England, United Kingdom

Abdullatif Aydin

The Urology Foundation Simulation Research Fellow
MRC Centre for Transplantation, Guy's Hospital, King's College London
London, England, United Kingdom

Sharanya Palaneer

Faculty of Life Sciences & Medicine, King's College London
Newcastle under Lyme , England, United Kingdom

Nicola Macchione

Italy, Lazio, Italy

Ahmed Al-Jabir

Medical student
GKT School of Medical Education, King's College London
London, England, United Kingdom

Shamim Khan

Department of Urology, Guy's and St. Thomas' NHS Foundation Trust
London, England, United Kingdom

Prokar Dasgupta

MRC Centre for Transplantation, King's College London
London, England, United Kingdom

Kamran Ahmed

MRC Centre for Transplantation, King's College London
London, England, United Kingdom