PDF herunterladen
Open Access
CC BY 4.0 · Endoscopy 2025; 57(S 01): E915-E916
DOI: 10.1055/a-2678-0183
E-Videos

Mixed-reality-based education with holographic support before and during ERCP-related procedures

Authors

  • Yuki Tanisaka 

    1   Department of Gastroenterology, Saitama Medical University International Medical Center, Hidaka, Japan (Ringgold ID: RIN183786)

  • Shomei Ryozawa

    1   Department of Gastroenterology, Saitama Medical University International Medical Center, Hidaka, Japan (Ringgold ID: RIN183786)

  • Takao Itoi

    2   Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan (Ringgold ID: RIN13112)

  • Masafumi Mizuide

    1   Department of Gastroenterology, Saitama Medical University International Medical Center, Hidaka, Japan (Ringgold ID: RIN183786)

  • Akashi Fujita 

    1   Department of Gastroenterology, Saitama Medical University International Medical Center, Hidaka, Japan (Ringgold ID: RIN183786)

  • Ryuichi Watanabe

    1   Department of Gastroenterology, Saitama Medical University International Medical Center, Hidaka, Japan (Ringgold ID: RIN183786)

  • Maki Sugimoto

    3   Innovation Lab, Teikyo University Okinaga Research Institute, Tokyo, Japan
Weitere Informationen
Auch verfügbar auf
  Lizenzen und Reprints
Preview

Endoscopic biliary drainage by endoscopic retrograde cholangiopancreatography (ERCP) in patients with malignant biliary obstruction requires a thorough understanding of the biliary anatomy, as well as accurate identification of the appropriate drainage area. However, achieving this level of understanding in trainee education can be challenging when relying on two-dimensional fluoroscopic images. Mixed reality (MR) is a technology that merges real-world and virtual elements in real time to create an integrated environment []. By wearing a dedicated head-mounted display and hand controllers (Meta Quest 3; Meta, USA), users can view holograms, which are computer-generated three-dimensional (3D) graphic models, from their desired perspective ([]). It has been reported that MR with holographic support is feasible for pancreatobiliary endoscopic procedures [] [] []. We report a case where ERCP was carried out in a patient with hilar bile duct cancer, in which MR-based education with holographic support was feasible.

Zoom
Mixed-reality-based education with holographic support. a A dedicated head-mounted display and hand controllers. b A doctor wearing a head-mounted display and using hand controllers. c A computer-generated three-dimensional (3D) graphic model seen through the head-mounted display. d The 3D model is rotatable.

A 68-year-old man with resectable hilar bile duct cancer was referred to us ([]). After discussion with surgeons, we planned to perform ERCP and biliary drainage of the left intrahepatic bile duct ([]). 3D polygon data of the bile duct was created from computed tomography using Synapse Vincent (Fujifilm Medical Co., Ltd., Japan) and Holoeyes MD software (Holoeyes Inc., Japan) ([]). Before the procedure, trainees received tuition from experts on the patient’s biliary anatomy and the drainage area while using MR with holographic support ([]). Furthermore, they also received tuition while viewing MR alongside fluoroscopic findings during the procedure ([]). Since the MR and fluoroscopic findings were comparable, this helped trainees’ understanding of the procedure. Finally, biliary drainage was performed in the area explained by the experts to the trainees before the procedure using MR.

Zoom
Computed tomogram showing the biliary stricture caused by bile duct cancer in the hilar bile duct of a 68-year-old man (arrows).
Zoom
Computed tomographic imaging converted into 3D polygon data.
Zoom
Before the procedure, trainees received tuition from experts on the patient’s biliary anatomy and the drainage area, using mixed reality with holographic support.
Zoom
Trainees also received tuition while viewing mixed reality with holographic support alongside fluoroscopic imaging during the procedure.
Herunterladen
Mixed-reality-based education with holographic support before and during endoscopic retrograde cholangiopancreatography–related procedures.

MR-based education with holographic support both before and during ERCP was feasible. This approach may represent an innovative educational technology for pancreatobiliary endoscopists.

Endoscopy_UCTN_Code_TTT_1AR_2AB

Endoscopy E-Videos https://eref.thieme.de/e-videos

E-Videos is an open access online section of the journal Endoscopy, reporting on interesting cases and new techniques in gastroenterological endoscopy. All papers include a high-quality video and are published with a Creative Commons CC-BY license. Endoscopy E-Videos qualify for HINARI discounts and waivers and eligibility is automatically checked during the submission process. We grant 100% waivers to articles whose corresponding authors are based in Group A countries and 50% waivers to those who are based in Group B countries as classified by Research4Life (see: https://www.research4life.org/access/eligibility/).

This section has its own submission website at https://mc.manuscriptcentral.com/e-videos.



Publikationsverlauf

Artikel online veröffentlicht:
20. August 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany