Enhancing patient comprehension in liver resection informed consent: A randomized controlled trial using augmented reality and 3D visualization technologies (EPIC-AR trial)

Background: Informed consent is a fundamental ethical requirement and a legal obligation in all surgical procedures. It involves a clear, mutual understanding between the patient and the surgeon about the nature of the surgery, potential risks, benefits, and alternatives. However, the complexity of surgical procedures, especially liver resection, poses significant challenges to the informed consent process. Traditional methods, predominantly verbal explanations supplemented by static images, often fall short in adequately conveying the intricate details of the surgery. This gap in understanding can lead to anxiety, dissatisfaction, and a lack of informed decision-making among patients. Previous research has demonstrated that three-dimensional (3D) presentations improve the identification of liver anatomy and 3D liver model-based surgical education improves preoperative decision-making and patient satisfaction. Recent advancements in augmented reality (AR) and 3D visualization technologies offer a more dynamic and interactive way of presenting complex surgical information, potentially enhancing patient understanding and satisfaction. However, the effectiveness of these technologies in the context of informed consent for liver resection remains underexplored. The primary objective of this trial, is to assess whether the use of AR and 3D visualization technologies can improve the clarity and effectiveness of informed consent dialogues compared to traditional methods.