Studying the Implications of Augmented Reality for Teamwork in Open Liver Surgery

Medical 3D imaging allows surgeons to analyse liver anatomy through reconstructed models, supporting planning and decision-making. As these reconstructions enter operating room, it remains unclear how best to integrate them into surgical workflows, and which display modalities are most effective. After mapping current practices through user research, we investigated four approaches to presenting 3D reconstructions in simulated open-liver surgery. Pairs of surgeons diagnose cases and proposed hepatectomy incision lines under four conditions: (1) 3D reconstructions on a 2D monitor, (2) Augmented Reality (AR) overlay on a 2D monitor, (3) AR overlay via head-mounted display (HMD) for the main surgeon and 2D monitor for the assistant, and (4) AR overlay via HMDs for both surgeons. Results showed that the HMD+HMD condition was preferred for supporting anatomical understanding and collaboration. While accuracy was unaffected, findings emphasise the importance of shared perspective for effective teamwork using AR.