Augmented Reality und Virtual Reality im Operationssaal – Status Quo und Quo vadis

Zusammenfassung

Einleitung Virtual Reality (VR) ist die künstlich simulierte Umgebung, mit der eine Interaktion möglich ist. Die Augmented Reality (AR) hingegen überlagert reale und künstliche Informationen. Beide Verfahren sind im Klinikalltag bereits vielerorts integriert und werden zunehmend auch für den chirurgischen Sektor beworben. Welche Möglichkeiten die vielfältigen Anwendungsmöglichkeiten bieten, ist dabei vielen Ärzten unklar.

Ziel Erfassung der aktuellen und zukünftigen Verwendung von AR und VR im perioperativen Umfeld sowie die Veranschaulichung der zu erwartenden Verbesserungen und Probleme durch diese neuen Technologien.

Methoden: Systematische Literaturrecherche der Medizinbibliothek PubMed mit Inklusion von Reviews, die Bezug nehmen auf das Thema AR und VR mit Fokus auf Artikel, die das perioperative Feld berühren. Schlagwörter waren: Augmented Reality, Virtual Reality, Telementoring, Telechirurgie („Telesurgery“). Zudem Durchführung einer Recherche innerhalb der Grauliteratur zur Analyse der Investitionsbereitschaft im Gesundheitswesen durch private Technologiekonzerne.

Resultate Zum Thema „Augmented Reality“ wurden 1222 Artikel bei 119 Reviews und zu „Virtual Reality“ 7766 Artikel bei 878 Reviews angezeigt. Die Anzahl der veröffentlichten Artikel ist dabei über die letzten Jahre hinweg stark zunehmend. 45 Artikel wurden eingeschlossen. Multiple AR- und VR-Geräte sind bereits im operativen Setting etabliert. Die nächsten vielversprechenden Anwendungsbereiche werden hier v. a. die intraoperative Überlagerung von bildgebenden Verfahren über AR-Geräte sowie das Telementoring und die vermehrte Anwendung im Bereich operativer bzw. anatomischer Ausbildung betreffen. Die zu erhoffenden Vorteile wie Senkung der Komplikationsrate, Kosteneinsparungen, flächendeckender Wissenszuwachs und Optimierung des chirurgischen Ergebnisses müssen erst in wissenschaftlichen Studien nachgewiesen werden. Aus der Recherche der Grauliteratur geht ein enormes finanzielles Bestreben der Technologiekonzerne in diesem Sektor hervor.

Schlussfolgerung AR und VR werden aufgrund ihres enormen Verbesserungspotenzials zunehmend in den perioperativen Sektor integriert. Dabei ist der Nutzen dieser Technologien für relevante Endpunkte weitestgehend unklar. Diese sollten in gut-designten klinischen Studien rigoros getestet werden. Ärzte sollten diese technische Revolution aktiv mitgestalten, um das enorme Potenzial von AR und VR zum Wohle ihrer Patienten auszuschöpfen.

Abstract

Introduction Virtual reality (VR) is an artificially simulated environment permitting interaction. On the other hand, augmented reality (AR) is an enhanced version of reality created by the use of technology to overlay digital information on an image of something being viewed through a device. Both technologies have partially been implemented in clinical daily routine. Surgical applications of VR and AR are currently evaluated. Yet it is still unclear which possibilities these new and versatile applications offer for physicians.

Intention The goal of this article was to assess current and future use of AR und VR, with a special focus on surgery. We also summarised obstacles for AR and VR use as well as potential clinical improvements through these new technologies.

Methods Systematic literature research in PubMed with inclusion of reviews referring to AR and VR, especially focused on articles on surgery. Keywords were Augmented Reality, Virtual Reality, Telementoring and Telesurgery. Furthermore we briefly analysed the investment volume and investment strategy in medicine from the ten largest private technology companies of the USA.

Results The keyword “Augmented Reality” leads to 1222 articles and 119 reviews, while “Virtual Reality” offered 7766 articles and 878 reviews. In recent years, the amount of published articles has increased. 45 articles were included. Multiple AR- and VR-applications are already integrated in surgical daily routine. The next promising applications will concern the possibility of intraoperative overlap with radiological imaging via AR-tools, as well as telementoring and the use of AR and VR in surgical and anatomical education. The expected – but unproven – advantages include cost savings, reduction in complications, comprehensive knowledge acquisition and improvement in surgical results. In addition, we notice enormous financial investment by technology companies in this sector.

Conclusion Due to their tremendous potential, AR and VR technologies will be increasingly integrated into surgery. However, the benefit of these new technologies for relevant endpoints are currently unclear. This should be examined in rigorous clinical trials. Physicians should play a key role in this technological revolution to exploit the potential of AR and VR for their patients.

Schlüsselwörter

Augmented Reality - Virtual Reality - Telementoring - Telechirurgie

Keywords

Augmented Reality - Virtual Reality - Telementoring - Telesurgery

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