Abstract
Background Augmented reality (AR) uses a set of technologies that overlays digital information
into the real world, giving the user access to both digital and real-world environments
in congruity. AR may be specifically fruitful in reconstructive microsurgery due to
the dynamic nature of surgeries performed and the small structures encountered in
these operations. The aim of this study was to conduct a high-quality preferred reporting
items for systematic reviews and meta-analyses (PRISMA) and assessment of multiple
systematic reviews 2 (AMSTAR 2) compliant systematic review evaluating the use of
AR in reconstructive microsurgery.
Methods A systematic literature search of Medline, EMBASE, and Web of Science databases was
performed using appropriate search terms to identify all applications of AR in reconstructive
microsurgery from inception to December 2018. Articles that did not meet the objectives
of the study were excluded. A qualitative synthesis was performed of those articles
that met the inclusion criteria.
Results A total of 686 articles were identified from title and abstract review. Five studies
met the inclusion criteria. Three of the studies used head-mounted displays, one study
used a display monitor, and one study demonstrated AR using spatial navigation technology.
The augmented reality microsurgery score was developed and applied to each of the
AR technologies and scores ranged from 8 to 12.
Conclusion Although higher quality studies reviewing the use of AR in reconstructive microsurgery
is needed, the feasibility of AR in reconstructive microsurgery has been demonstrated
across different subspecialties of plastic surgery. AR applications, that are reproducible,
user-friendly, and have clear benefit to the surgeon and patient, have the greatest
potential utility. Further research is required to validate its use and overcome the
barriers to its implementation.
Keywords augmented reality - reconstruction - technology
