Mixed reality applications in urology: Requirements and future potential

BACKGROUND: Mixed reality (MR), the computer-supported augmentation of a real environment with virtual elements, becomes ever more relevant in the medical domain, especially in urology, ranging from education and training over surgeries. We aimed to review existing MR technologies and their applications in urology. METHODS: A non-systematic review of current literature was performed using the PubMed-Medline database using the medical subject headings (MeSH) term "mixed reality", combined with one of the following terms: "virtual reality", "augmented reality", ''urology'' and "augmented virtuality". The relevant studies were utilized. RESULTS: MR applications such as MR guided systems, immersive VR headsets, AR models, MR-simulated ureteroscopy and smart glasses have enormous potential in education, training and surgical interventions of urology. Medical students, urology residents and inexperienced urologists can gain experience thanks to MR technologies. MR applications are also used in patient education before interventions. CONCLUSIONS: For surgical support, the achievable accuracy is often not sufficient. The main challenges are the non-rigid nature of the genitourinary organs, intraoperative data acquisition, online and multimodal registration and calibration of devices. However, the progress made in recent years is tremendous in all respects and the gap is constantly shrinking.