Telestration with augmented reality in minimally invasive and robotic-assisted surgery: a scoping review.

BACKGROUND: Minimally Invasive Surgery (MIS) and Robotic-Assisted Surgery (RAS) offer advantages over open surgery, including smaller incisions and quicker recovery. However, the learning curve in MIS and RAS presents several challenges, primarily due to their reliance on verbal instructions. MIS and RAS training is continually evolving, with new educational and simulation models emerging in recent years. Telestration, combined with augmented reality (AR), enables annotating videos and images as active feedback during surgery. These modalities have been used in the operating room to highlight anatomical structures, aiding visual communication and reinforcing verbal communication in MIS and RAS. This study aimed to provide a scoping review of the use, current applications, and development of telestration and with AR in MIS and RAS. METHODS: A scoping review was conducted using the Joanna Briggs Institute methodology and the PRISMA extension for scoping reviews (PRISMA-ScR) 2018 statement and recommendations. Two researchers independently searched the literature in the following databases: PubMed, the Association for Computing Machinery (ACM), the Institute of Electrical and Electronics Engineers (IEEE), and Google Scholar. RESULTS: From a total of 625 screened studies, 33 were included in the scoping review based on relevance, reported innovation, clinical and surgical implementation, and potential benefits in MIS and RAS. Intraoperative surgical guidance using telestration with AR has already been implemented in the MIS and RAS fields, such as urology, colorectal surgery, gynecology, and orthopedics. Telestration with AR is increasingly used in MIS and RAS simulation and training. This technology optimizes communication during surgical procedures, reduces complication rates, and enhances performance, potentially leading to improved patient outcomes. CONCLUSION: Telestration with AR is an innovative tool in MIS and RAS that improves surgical training, communication, and idea exchange, sometimes replacing on-site mentoring.