New head-mounted display system applied to endoscopic management of upper urinary tract carcinomas

Junichiro Ishioka, Kazunori Kihara, Saori Higuchi, Takayuki Nakayama, Hideki Takeshita, Soichiro Yoshida, Yasukazu Nakanishi, Toshiki Kijima, Yoh Matsuoka, Noboru Numao, Kazutaka Saito, Yasuhisa Fujii

Purpose: We tested a new head-mounted display (HMD) system for surgery on the upper urinary tract. Surgical Technique: Four women and one man with abnormal findings in the renal pelvis on computed tomography and magnetic resonance imaging underwent surgery using this new system. A high definition HMD (Sony, Tokyo, Japan) is connected to a flexible ureteroscope (Olympus, Tokyo, Japan) and the images from the ureteroscope are delivered simultaneously to various participants wearing HMDs. Furthermore, various information in addition to that available through the endoscope, such as the narrow band image, the fluoroscope, input from a video camera mounted on the lead surgeon's HMD and the vital monitors can be viewed on each HMD. Results: Median operative duration and anesthesia time were 53 and 111 minutes, respectively. The ureteroscopic procedures were successfully performed in all cases. There were no notable negative outcomes or incidents (Clavien-Dindo grade ≥1). Conclusion: The HMD system offers simultaneous, high-quality magnified imagery in front of the eyes, regardless of head position, to those participating in the endoscopic procedures. This affordable display system also provides various forms of information related to examinations and operations while allowing direct vision and navigated vision.