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Systematic review of augmented reality in urological interventions: the evidences of an impact on surgical outcomes are yet to come

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Abstract

Purpose

To perform a systematic literature review on the clinical impact of augmented reality (AR) for urological interventions.

Methods

As of June 21, 2018, systematic literature review was performed via Medline, Embase and Cochrane databases in accordance with the PRISMA guidelines and registered at PROSPERO (CRD42018102194). Only full text articles in English were included, without time restrictions. Articles were considered if they reported on the use of AR during urological intervention and the impact on the surgical outcomes. The risk of bias and the quality of each study included were independently assessed using the standard Cochrane Collaboration risk of bias tool and the Risk Of Bias In Non-randomised Studies—of Interventions Tool (ROBINS-I).

Results

131 articles were identified. 102 remained after duplicate removal and were critically reviewed for evidence synthesis. 20 studies reporting on the outcomes of the use of AR during urological interventions in a clinical setting were considered. Given the mostly non-comparative design of the studies identified, the evidence synthesis was performed in a descriptive and narrative manner. Only one comparative study was found, with the remaining 19 items being single-arm observational studies. Based on the existing evidence, we are unable to state that AR improves the outcomes of urological interventions. The major limitation of AR-assisted surgery is inaccuracy in registration, translating into a poor navigation precision.

Conclusions

To date, there is limited evidence showing superior therapeutic benefits of AR-guided surgery when compared with the conventional surgical approach to the respective disease.

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Author information

Authors and Affiliations

  1. Glickman Urological and Kidney Institute, Cleveland Clinic, 2050 E 96th St, Q Building, Cleveland, OH, 44195, USA

    Riccardo Bertolo

  2. Urology Department, “San Carlo di Nancy” Hospital, Rome, Italy

    Riccardo Bertolo & Pierluigi Bove

  3. Center for Robotic Simulation and Education, Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, University of Southern California, Los Angeles, CA, USA

    Andrew Hung

  4. Division of Urology, Department of Oncology, University of Turin, San Luigi Hospital, Orbassano, Turin, Italy

    Francesco Porpiglia

  5. Floyd D. Loop Alumni Library, Cleveland Clinic, Cleveland, OH, USA

    Mary Schleicher

  6. King’s College London, Guy’s Hospital, London, UK

    Prokar Dasgupta

Authors
  1. Riccardo Bertolo
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  2. Andrew Hung
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  3. Francesco Porpiglia
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  4. Pierluigi Bove
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  5. Mary Schleicher
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  6. Prokar Dasgupta
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Contributions

Protocol/project development: RB, PD, AH. Data collection or management: RB, MS. Data analysis: RB, AH. Manuscript writing: RB. Manuscript editing: PB, PD, AH, FP.

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Correspondence to Riccardo Bertolo.

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Bertolo, R., Hung, A., Porpiglia, F. et al. Systematic review of augmented reality in urological interventions: the evidences of an impact on surgical outcomes are yet to come. World J Urol 38, 2167–2176 (2020). https://doi.org/10.1007/s00345-019-02711-z

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  • DOI: https://doi.org/10.1007/s00345-019-02711-z

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