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Mixed Reality with HoloLens: Where Virtual Reality Meets Augmented Reality in the Operating Room

Tepper, Oren M. M.D.; Rudy, Hayeem L. B.A.; Lefkowitz, Aaron B.A.; Weimer, Katie A. M.A.; Marks, Shelby M. M.A.; Stern, Carrie S. M.D.; Garfein, Evan S. M.D.

Plastic and Reconstructive Surgery: November 2017 - Volume 140 - Issue 5 - p 1066-1070
doi: 10.1097/PRS.0000000000003802
Special Topics: Ideas and Innovations
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Summary: Virtual reality and augmented reality devices have recently been described in the surgical literature. The authors have previously explored various iterations of these devices, and although they show promise, it has become clear that virtual reality and/or augmented reality devices alone do not adequately meet the demands of surgeons. The solution may lie in a hybrid technology known as mixed reality, which merges many virtual reality and augmented realty features. Microsoft’s HoloLens, the first commercially available mixed reality device, provides surgeons intraoperative hands-free access to complex data, the real environment, and bidirectional communication. This report describes the use of HoloLens in the operating room to improve decision-making and surgical workflow. The pace of mixed reality–related technological development will undoubtedly be rapid in the coming years, and plastic surgeons are ideally suited to both lead and benefit from this advance.

Bronx, N.Y.; and Rock Hill, S.C.

From the Department of Surgery, Division of Plastic and Reconstructive Surgery, and the Department of Otorhinolaryngology–Head and Neck Surgery, Montefiore Medical Center/Albert Einstein College of Medicine; and 3D Systems Corp.

Received for publication October 2, 2016; accepted June 19, 2017.

Disclosure:The authors have the following to disclose: Dr. Evan Garfein is a consultant for Stryker and the founder of Sigma Surgical. Dr. Oren Tepper is a consultant for Stryker CMF Dr. Carrie Stern is founder of MirrorMe3D. Katie Weimer and Shelby Marks are employed by 3D Systems Corporation.

A “Hot Topic Video” by Editor-in-Chief Rod J. Rohrich, M.D., accompanies this article. Go to and click on “Plastic Surgery Hot Topics” in the “Digital Media” tab to watch. On the iPad, tap on the Hot Topics icon.

Evan S. Garfein, M.D., Department of Surgery, Division of Plastic and Reconstructive Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, 1250 Waters Place, 6th Floor, Bronx, N.Y. 10465

Copyright © 2017 by the American Society of Plastic Surgeons