SYSTEMATIC REVIEW article
Front. Surg.
Sec. Surgical Oncology
This article is part of the Research TopicArtificial Intelligence in Surgical Oncology: Current Applications, Challenges, and Future DirectionsView all articles
The digital evolution of surgical planning: A systematic review of immersive and interactive technologies
Provisionally accepted
Waleed Daifallah Khubzan*
Rimas Warid Aljuaid
Shuruq Awad AlharthiDhay Saleem AlgethamiSuhaiyh Sanad AlotibiHaya Mesfer Alotaibi
Shaden Sultan AljuaidRemas Salem Almalki
Mohammad Eid M. Mahfouz- Taif University, Ta'if, Saudi Arabia
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Background Immersive and interactive technologies such as Virtual Reality (VR), Augmented Reality (AR), and Mixed Reality (MR) are reshaping surgical planning by enhancing anatomical visualization, enabling personalized procedures, and improving intraoperative navigation and decision-making across diverse surgical specialties. Methods This systematic review was conducted in accordance with the PRISMA guidelines, and was registered in PROSPERO (CRD420251066149), analyzing 30 studies (1,270 participants) from PubMed, Google Scholar Web of Science and Ovid MEDLINE up to February 2025. Included studies evaluated VR, AR, or MR in preoperative or intraoperativesurgical planning, reporting outcomes on accuracy, time efficiency, or plan modifications. Risk of bias was assessed using RoB 2.0 for RCTs and ROBINS-I for non-randomized studies. Results VR was the most utilized technology (17 studies), improving spatial understanding and prompting plan modifications in 32–52% of cases (e.g., lung segmentectomies, TAVR). AR (8 studies) enhanced intraoperative accuracy, reducing pedicle screw placement errors (98% vs. 91.7% control) and procedure times (e.g., 50% faster spinal screw placement). MR (2 studies) demonstrated potential in reducing thoracic epidural needle adjustments (7.2 vs. 14.4 movements) and sentinel node biopsy durations (3.6 vs. 7.9 minutes). Heterogeneity in study designs and outcomes limited meta-analysis. Conclusion VR enhanced anatomical understanding and preoperative planning, while AR, and MR were better for procedural accuracy and intraoperative workflow. Future multicenter trials with standardized protocols are needed to establish long-term clinical efficacy and cost-effectiveness in diverse surgical settings.
Keywords: augmented reality, Immersive technology, Intraoperative navigation, Mixed reality, Preoperative Visualization, surgical planning, Systematic review, virtual reality
Received: 09 Dec 2025; Accepted: 06 Feb 2026.
Copyright: © 2026 Khubzan, Aljuaid, Alharthi, Algethami, Alotibi, Alotaibi, Aljuaid, Almalki and Mahfouz. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Waleed Daifallah Khubzan
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