Feasibility study of a mixed reality ⁃ based multimodal head ⁃ mounted intraoperative neurosurgical monitoring system

Objective To introduce the application process of a mixed reality (MR)⁃based multimodal head⁃mounted intraoperative neurosurgical montioring system and its integration into intraoperative applications, and to evaluate the clinical efficacy of this system for monitoring during neurosurgical intraoperative radiotherapy. Methods A MR⁃based multimodal head⁃mounted intraoperative neurosurgical monitoring system was used to assist anesthesiologists in real⁃time monitoring of patients' vital signs and operation area during radiotherapy in neurosurgical surgery. Before the use of the system, the simulation test was used to record the delay time of video signal streaming. Before the start of radiotherapy in neurosurgery, the system preparation time was recorded. After the operation, an self⁃designed electronic questionnaire was used to investigate the satisfaction of anesthesiologists with the use of the system. Results The system has been successfully used in 23 cases of neurosurgical intraoperative radiotherapy. No technical failures or related complications occurred. The quantitative delay test showed median time of video signal streaming delay measured by simulation test was 160 ms. The system preparation time decreased from 32 min at the beginning of the study to 4-5 min. A total of 14 anesthesiologists were received the questionnaire survey, and the satisfaction score was 30.43. Conclusions The MR⁃based multimodal head⁃mounted intraoperative neurosurgical monitoring system is applied during neurosurgical intraoperative radiotherapy to assist anesthesiologists in real⁃time monitoring of patients' vital signs and the environment of the operation area, which has a good prospect of popularization and transformation.