See-through type 3D head-mounted display-based surgical microscope system for microsurgery: A feasibility study

Cheol Hwan Kim, Seon Young Ryu, Ji Young Yoon, Hyoung Kwon Lee, Nak Gu Choi, Il Ho Park, Hae Young Choi

    Research output: Contribution to journalArticlepeer-review

    7 Citations (Scopus)


    Background: The surgical microscope is used primarily for microsurgeries, which are more complicated than other surgical procedures and require delicate tasks for a long time. Therefore, during these surgical procedures, surgeons experience back and neck pain. To solve this problem, new technology, such as wearable displays, is required to help surgeons maintain comfortable postures and enjoy advanced functionality during microsurgery. Objective: The objective of this study was to develop a surgical microscope system that would work with wearable devices. It would include a head-mounted display (HMD) that can offer 3D surgical images and allow a flexible and comfortable posture instead of fixed eyepieces of surgical microscope and can also provide peripheral visual field with its optical see-through function. Methods: We designed and fabricated a surgical microscope system that incorporates a see-through type 3D HMD, and we developed an image processing software to provide better image quality. The usability of the proposed system was confirmed with preclinical examination. Seven ENT (ear, nose, and throat) surgical specialists and 8 residents performed a mock surgery—axillary lymph node dissection on a rat. They alternated between looking through the eyepieces of the surgical microscope and viewing a 3D HMD screen connected to the surgical microscope. We examined the success of the surgery and asked the specialists and residents to grade eye fatigue on a scale of 0 (none) to 6 (severe) and posture discomfort on a scale of 1 (none) to 5 (severe). Furthermore, a statistical comparison was performed using 2-tailed paired t test, and P=.00083 was considered significant. Results: Although 3D HMD case showed a slightly better result regarding visual discomfort (P=.097), the average eye fatigue was not significantly different between eyepiece and 3D HMD cases (P=.79). However, the average posture discomfort, especially in neck and shoulder, was lower with 3D HMD display use than with eyepiece use (P=.00083). Conclusions: We developed a see-through type 3D HMD–based surgical microscope system and showed through preclinical testing that the system could help reduce posture discomfort. The proposed system, with its advanced functions, could be a promising new technique for microsurgery.

    Original languageEnglish
    Article numbere11251
    JournalJMIR mHealth and uHealth
    Issue number3
    Publication statusPublished - 2019 Mar

    Bibliographical note

    Funding Information:
    This work was supported by the Economic and Regional Cooperation Industry program funded by the Ministry of Trade, Industry & Energy; the Information & Communication Technology Research and Development Program of Institute for Information & Communications Technology (ICT) Promotion Ministry of Science and ICT (2014-0-00230) and the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education (2017R1D1A1B03034681).

    Publisher Copyright:
    © Curtis L Petersen, William B Weeks, Olof Norin, James N Weinstein.


    • 3D imaging
    • Head-mounted display
    • Microsurgery
    • Surgical microscope

    ASJC Scopus subject areas

    • Health Informatics


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