Application of a head-mounted augmented reality display for visualization in convexity meningioma resection: A technical note

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Abstract
Background: Head-mounted augmented reality (AR) displays are a promising innovation in neurosurgical visualization, offering the potential to improve ergonomics and team coordination compared to traditional operating microscopes. Surgeons frequently experience physical strain due to fixed postures during long procedures, contributing to work-related musculoskeletal disorders. This technical note reports on the first clinical use of an AR headset during convexity meningioma resection. Methods: An 82-year-old female patient underwent surgical resection of a left convexity meningioma using an AR visualization system (Leica MyVeo). The headset displayed the microscope feed directly into the surgeon’s and assistant’s field of view, allowing both to maintain ergonomic postures throughout the operation. A post-procedural questionnaire and rapid entire body assessment (REBA) scores were used to evaluate ergonomics and workflow. Results: The AR headset was rated positively for improving team coordination and visualization continuity. Both surgeon and assistant reported increased comfort and reduced strain during the procedure. REBA scores indicated low ergonomic risk (3 for the surgeon, 2 for the assistant), suggesting an improvement over typical scores reported for microscope-based surgery. The tumor was completely resected without complications, and the patient had an uneventful postoperative course. Conclusion: This initial experience demonstrates that AR headsets can be safely integrated into neurosurgical workflows, offering significant ergonomic and collaborative advantages. These findings support further investigation into AR-assisted visualization as a complementary tool to traditional operative microscopy.

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