Intraoperative mixed reality support for endoscopic submucosal dissection of a large laterally spreading tumor in the rectum

Mixed reality is a novel technology that adds digital elements to the real world to blend virtual and physical experiences. Recently, mixed reality has gained attention as a real-time intraoperative support modality that enhances the operator's spatial awareness for detecting organs and vessels [1]. Colorectal endoscopic submucosal dissection (ESD) is widely used as a minimally invasive treatment; however, owing to its technical difficulty, endoscopists experience various levels of stress during the procedure regarding the possibility of perforation and bleeding. Mixed reality might help endoscopists accurately comprehend anatomical structures during ESD, preventing intraoperative adverse events without endoscopist stress. This is the first case report of intraoperative mixed reality support during colorectal ESD.