Objective: Since Augmented Reality (AR) and 3D visualization have proven to be of great significance to the safety and effectiveness of surgical outcomes, will autostereoscopic 3D AR without glasses bring new opportunities for surgical navigation of laparoscopic surgery? Methods: We used the CPD-based deformation registration algorithm and the proposed virtual view generation algorithm, realizing a deformable autostereoscopic 3D AR navigation framework for laparoscopic surgery. The depth perception and user experience of the 3D AR navigation were evaluated compared with the 2D AR display using an in-vitro porcine heart and offline clinical partial nephrectomy laparoscopic images. Results: The autostereoscopic 3D AR allowed participants to have a more consistent spatial perception as well as a shorter measuring time than 2D AR with significant difference of p<0.05. It can also improve relative depth perception for smaller distance separation of objects < = 3.28 mm. However, the autostereoscopic 3D AR perceived a worse experience compared to 2D AR in the user experience. Conclusion: Autostereoscopic 3D AR shows a more efficient and robust sense of spatial scale than 2D AR with better potential to shorten the operating time and improve surgical outcomes than 2D AR, but image blur and distortion are issues that must be solved to improve the perception effect. High precise registration and high fluency visualization requirements could make autostereoscopic 3D AR navigation for soft tissue more challenging. Significance: Our work lays a theoretical foundation for the further development of laparoscopic surgical navigation.

Conventional anatomical models and cadaveric specimens can be time-consuming and resource intensive for any anatomical institute. In recent years, there has been a push for more flexible and varied approaches to teaching, including problem-based and computer-aided learning, which includes web-based anatomical models or the use of three-dimensional visualization technology. With advances in hardware, autostereoscopic (AS) 3D screens have become more affordable, portable, and accessible to individuals, not just institutes. At King’s College London (KCL), we developed the Virtual Anatomy and Histology (VAH) platform—an online resource which focuses on perspective volumetric 3D viewing of medical scan data and 3D models to facilitate the online teaching and learning of anatomy. This paper presents the features of VAH and details a study that was conducted in 2022, to evaluate the VAH 3D AS viewer configured with The Looking Glass Portrait (TLG) (Looking Glass, New York, NY, USA) 8-inch AS display. We tested the hypothesis that using an AS display can improve spatial understanding of cardiovascular anatomy. A cardiovascular 3D textured model was used from our gallery to carry out a spatial test. Twenty current healthcare students at King’s participated in the study and completed a structured questionnaire. Results showed that 47.6% and 52.4% of participants agreed and strongly agreed, respectively, that identifying anatomical structures was easier in 3D compared to 2D. Qualitative feedback was positive as most students found King’s VAH and TLG display “useful for people who need help with spatial understanding” and that “it was a good tool to test your anatomical knowledge”. In conclusion, based on the quantitative results and feedback, we are optimistic that King’s VAH and portable AS displays can be beneficial in anatomy education. With the increasing availability of such systems and competitive pricing, this technology is likely to have a significant impact in education in coming years.