Holographic mixed reality navigation system ⁃ assisted microsurgery of the supratentorial tumor

Objective To summarize the clinical experience of supratentorial tumor resection using a wireless head ‐ mounted display (HMD)‐based holographic mixed reality navigation system (MRN). Methods A analysis was performed on 5 patients undergoing supratentorial tumor resection using holographic MRN at Zhuhai People's Hospital from March to September 2024. Preoperative imaging data were imported into 3D Slicer software to generate holograms of lesions, anatomical landmarks, and adjacent structures, which were subsequently integrated into the holographic MRN and projected onto the patient's head for preoperative incision planning and intraoperative tumor resection guidance. The convenience and stability of holographic MRN were evaluated by assessing navigation registration time, navigation application time, and registration attempts. Accuracy, efficacy, and safety of holographic MRN were analyzed through evaluation of bone window extent, tumor‐to‐surrounding structure relationships, modeling time tumor localization, Karnofsky Performance Status (KPS) scores, and surgical indicators. Results Preoperative modeling was all successfully completed, with an average modeling time (25.20 ± 1.60) min, and average registration time (3.20 ± 0.05) min. The mean preoperative and intraoperative navigation application times were (12.74 ± 1.09) and (8.17 ± 0.81) min, respectively. All registrations were successful on the first attempt. All lesions were entirely within the planned bone window boundaries, with no under‐ or over‐exposure. Holographic projections of tumors fully overlapped with actual intraoperative lesions. All 5 cases achieved Simpson grade Ⅰ resection. The average KPS score at 72 h after surgery was 94.00 ± 4.90. Conclusions This study confirms the convenience, stability, accuracy, efficacy, and safety of holographic MRN in clinical practice, demonstrating its value as an adjunctive tool for supratentorial tumor craniotomy.