Background: Laparoscopic surgery training is a demanding process requiring technical and nontechnical skills. Surgical training has evolved from traditional approaches to the use of immersive digital technologies such as virtual, augmented, and mixed reality. These technologies are now integral to laparoscopic surgery training. Objective: This scoping literature review aimed to analyze the current augmented reality (AR) solutions used in laparoscopic surgery training. Methods: Following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines, we conducted a scoping review using 4 databases: Scopus, IEEE Xplore, PubMed, and ACM. Inclusion and exclusion criteria were applied to select relevant articles. Exclusion criteria were studies not using AR, not focused on laparoscopic surgery, not focused on training, written in a language other than English, or not providing relevant information on the topics studied. After selecting the articles, research questions (RQs) were formulated to guide the review. In total, 2 independent reviewers then extracted relevant data, and a descriptive analysis of the results was conducted. Results: Of 246 initial records, 172 (69.9%) remained after removing duplicates. After applying the exclusion criteria, 76 articles were selected, with 25 (33%) later excluded for not meeting quality standards, leaving 51 (67%) in the final review. Among the devices analyzed (RQ 1), AR video–based devices were the most prevalent (43/51, 84%). The most common information provided by AR devices (RQ 1) focused on task execution and patient-related data, both appearing in 20% (10/51) of studies. Regarding sensorization (RQ 2), most studies (46/51, 90%) incorporated some form of sensorized environment, with computer vision being the most used technology (21/46, 46%) and the trainee the most frequently sensorized element (41/51, 80%). Regarding training setups (RQ 3), 39% (20/51) of the studies used commercial simulators, and 51% (26/51) made use of artificial models. Concerning the evaluation methods (RQ 4), objective evaluation was the most used, featured in 71% (36/51) of the studies. Regarding tasks (RQ 5), 43% (22/51) of studies focused on full surgical procedures, whereas 57% (29/51) focused on simple training tasks, with suturing being the most common among the latter (11/29, 38%). Conclusions: This scoping review highlights the evolving role of AR technologies in laparoscopic surgery training, although the impact of optical see-through devices remains unclear due to their limited use. It underscores the potential of emerging technologies such as haptic feedback, computer vision, and eye tracking to further enhance laparoscopic skill acquisition. While most relevant articles from other databases were included, some studies may have been missed due to the specific databases and search strategies used. Moreover, the need for standardized evaluation metrics is emphasized, paving the way for future research into AR’s full potential in laparoscopic skill acquisition.

This study aims to develop a system based on mixed reality imaging for assistance in percutaneous ultrasound‐guided liver interventions. A liver phantom, an ultrasound scanner with an abdominal probe, an electromagnetic tracking system for localization of the ultrasound probe, and the percutaneous needle were used to develop the system. A gelatin liver phantom was fabricated, including a set of lesions (with agarose, glycerol, and sephadex) and artificial blood vessels 3D printed with thermoplastic polyurethane (TPU) elastic fibres. Intraoperative ultrasound images from a BK5000 ultrasound scanner were acquired using a video capture system and transmitted to 3D Slicer. The NDI Aurora electromagnetic tracking system, coupled to the ultrasound probe and intracorporeal needle, was used for real‐time trajectory tracking, providing us with spatial localization information. These images are then sent to the augmented reality HoloLens device as the primary visualization system. This work lays the groundwork for the development of a more comprehensive system to assist ultrasound‐guided percutaneous liver interventions in order to improve the accuracy and safety of these procedures. The use of mixed reality imaging technology allows a better integration of image‐guided surgery systems, such as the one presented in this work, in real clinical environments, and closer to the patient.

Precise intraoperative identification of the canine thoracic duct remains challenging due to anatomical variability and limited visualization. This exploratory cadaveric feasibility study aimed to describe the technical applicability of fluorescence-guided thoracic duct mapping using video-assisted thoracoscopy (VATS) and robot-assisted thoracoscopy (Versius™ system). Four adult Beagle cadavers underwent bilateral thoracoscopic exploration after intranodal injection of indocyanine green (ICG, Verdye^®, 0.05 mg/kg; 0.5 mL). Near-infrared (NIR) fluorescence imaging enabled real-time visualization of the thoracic duct and its branches. Fluorescence quality was quantitatively characterized using signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and contrast resolution (CR) calculated from standardized image frames. Both approaches achieved successful duct identification in all cadavers. VATS provided brighter overall fluorescence, whereas the robotic-assisted approach offered stable imaging, enhanced instrument dexterity, and improved duct-to-background discrimination. These findings confirm the feasibility of fluorescence-guided thoracic duct identification using both minimally invasive modalities in canine cadavers. The standardized assessment of optical parameters proposed here may support future in vivo studies to optimize imaging protocols and evaluate the clinical impact of fluorescence-guided thoracic duct surgery in dogs.

Background: Laparoscopic surgery has advanced significantly; however, effective communication within the surgical team remains challenging, particularly in training scenarios where misinterpretation of instructions can lead to errors. Virtual pointers, indicating the instructor’s gaze through eye-tracking devices and overlaying it onto the screen using augmented reality (AR), can enhance understanding and reduce errors. Methods: In a study involving 10 participants divided into experts and novices in laparoscopic surgery, various pointers (differing in shape, size and colour) were analysed in an AR environment using the HoloLens2 device. The aim was to assess the acceptance of these pointers by both groups, understand how their characteristics affect perception, and evaluate the AR device’s usefulness. Results: Initial results showed an 80% acceptance rate. After analysing the pointers, this decreased to 60%, as some experts changed their opinion from positive to neutral. The study revealed that the characteristics of the pointers significantly affect their perception, with large, thick-rimmed pointers being preferred. Orange was the best-performing colour. The device used also influenced perception, as experts who changed their perception criticised certain aspects of the head-mounted display. Conclusions: The study highlights the potential of virtual pointers to improve communication in laparoscopic training, particularly when their size, shape, and colour are optimised. Further research with a larger sample size is needed to confirm these results and explore the HoloLens2’s influence on users’ perceptions. These insights could guide the development of more effective training tools for minimally invasive surgery.

BACKGROUND Laparoscopic surgery training is a demanding process requiring technical and nontechnical skills. Surgical training has evolved from traditional approaches to the use of immersive digital technologies such as virtual, augmented, and mixed reality. These technologies are now integral to laparoscopic surgery training. OBJECTIVE This scoping literature review aimed to analyze the current augmented reality (AR) solutions used in laparoscopic surgery training. METHODS Following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines, we conducted a scoping review using 4 databases: Scopus, IEEE Xplore, PubMed, and ACM. Inclusion and exclusion criteria were applied to select relevant articles. Exclusion criteria were studies not using AR, not focused on laparoscopic surgery, not focused on training, written in a language other than English, or not providing relevant information on the topics studied. After selecting the articles, research questions (RQs) were formulated to guide the review. In total, 2 independent reviewers then extracted relevant data, and a descriptive analysis of the results was conducted. RESULTS Of 246 initial records, 172 (69.9%) remained after removing duplicates. After applying the exclusion criteria, 76 articles were selected, with 25 (33%) later excluded for not meeting quality standards, leaving 51 (67%) in the final review. Among the devices analyzed (RQ 1), AR video–based devices were the most prevalent (43/51, 84%). The most common information provided by AR devices (RQ 1) focused on task execution and patient-related data, both appearing in 20% (10/51) of studies. Regarding sensorization (RQ 2), most studies (46/51, 90%) incorporated some form of sensorized environment, with computer vision being the most used technology (21/46, 46%) and the trainee the most frequently sensorized element (41/51, 80%). Regarding training setups (RQ 3), 39% (20/51) of the studies used commercial simulators, and 51% (26/51) made use of artificial models. Concerning the evaluation methods (RQ 4), objective evaluation was the most used, featured in 71% (36/51) of the studies. Regarding tasks (RQ 5), 43% (22/51) of studies focused on full surgical procedures, whereas 57% (29/51) focused on simple training tasks, with suturing being the most common among the latter (11/29, 38%). CONCLUSIONS This scoping review highlights the evolving role of AR technologies in laparoscopic surgery training, although the impact of optical see-through devices remains unclear due to their limited use. It underscores the potential of emerging technologies such as haptic feedback, computer vision, and eye tracking to further enhance laparoscopic skill acquisition. While most relevant articles from other databases were included, some studies may have been missed due to the specific databases and search strategies used. Moreover, the need for standardized evaluation metrics is emphasized, paving the way for future research into AR’s full potential in laparoscopic skill acquisition.