Abstract Rationale Bronchoscopic procedures demand high levels of visual-motor coordination and cognitive multitasking, which can be hampered by bulky monitors and large equipment. Spatial computing platforms like the Apple Vision Pro (AVP) offer the potential to streamline workflow by anchoring procedural imaging directly within the operator’s field of view. While prior work has explored augmented reality (AR) in surgical contexts, data on its real-world feasibility and cognitive impact in bronchoscopy remain limited. This pilot study investigates AVP-assisted bronchoscopy during interventional pulmonary procedures to assess impact on operator workload and perceived usability. Methods This single-center feasibility study was conducted by three attending interventional pulmonologists and one interventional pulmonary fellow at UC San Diego. Thirty augmented reality bronchoscopic procedures—including rigid, flexible, and robotic techniques—were performed using the Apple Vision Pro (AVP) headset to display real-time procedural video and imaging within the operator’s visual field. After each case, operators completed the NASA Task Load Index (NASA-TLX) to assess perceived cognitive workload. Control scores were obtained from comparable non-AVP procedures performed by the same clinicians. NASA-TLX scores were compared using Welch’s unpaired two-tailed t-test, selected to account for heteroscedasticity in data (unequal variances and unbalanced sample sizes between groups). Results All thirty bronchoscopic cases were completed successfully with the AVP headset. Mean NASA-TLX scores decreased from 42.5 ± 16.6 (control) to 30.1 ± 21.3 (AVP) (p = 0.041). Task-load reductions were observed across procedural modalities—rigid (52.3 ± 18.8 to 28.1 ± 29.2), flexible (30.3 ± 14.4 to 27.7 ± 29.5), and robotic (48.3 ± 8.8 to 30.8 ± 20.0)—though subgroup sizes were underpowered for significance testing. Setup time averaged five minutes. Users consistently reported ergonomic benefits, including improved visualization alignment and reduced neck strain. Noted limitations included perceived differences in image color and resolution compared to standard SDI monitors, feeling warm during longer cases, and isolated connectivity issues with video encoders. Conclusions These findings demonstrate the feasibility of integrating spatial computing into bronchoscopic workflow using a commercially available headset. AVP-assisted procedures were completed without disruption, with setup times that fit within routine practice and consistent reductions in perceived task load. While technical limitations remain—including occasional hardware interruptions and lack of integration with clinical systems—operators reported meaningful ergonomic and workflow benefits. Further development and real-world evaluation are warranted to optimize AR implementation in bronchoscopic procedures. This abstract is funded by: None
Sekhon et al. (Fri,) studied this question.