Augmented reality and virtual reality in the operating theatre status quo und quo vadis

Introduction Virtual reality (VR) is an artificially simulated environment permitting interaction. On the other hand, augmented reality (AR) is an enhanced version of reality created by the use of technology to overlay digital information on an image of something being viewed through a device. Both technologies have partially been implemented in clinical daily routine. Surgical applications of VR and AR are currently evaluated. Yet it is still unclear which possibilities these new and versatile applications offer for physicians. Intention The goal of this article was to assess current and future use of AR und VR, with a special focus on surgery. We also summarised obstacles for AR and VR use as well as potential clinical improvements through these new technologies. Methods Systematic literature research in PubMed with inclusion of reviews referring to AR and VR, especially focused on articles on surgery. Keywords were Augmented Reality, Virtual Reality, Telementoring and Telesurgery. Furthermore we briefly analysed the investment volume and investment strategy in medicine from the ten largest private technology companies of the USA. Results The keyword "Augmented Reality" leads to 1222 articles and 119 reviews, while "Virtual Reality" offered 7766 articles and 878 reviews. In recent years, the amount of published articles has increased. 45 articles were included. Multiple AR- and VR-applications are already integrated in surgical daily routine. The next promising applications will concern the possibility of intraoperative overlap with radiological imaging via AR-tools, as well as telementoring and the use of AR and VR in surgical and anatomical education. The expected - but unproven - advantages include cost savings, reduction in complications, comprehensive knowledge acquisition and improvement in surgical results. In addition, we notice enormous financial investment by technology companies in this sector. Conclusion Due to their tremendous potential, AR and VR technologies will be increasingly integrated into surgery. However, the benefit of these new technologies for relevant endpoints are currently unclear. This should be examined in rigorous clinical trials. Physicians should play a key role in this technological revolution to exploit the potential of AR and VR for their patients.