Augmented Reality, Mixed Reality, Computer Vision, and Three-Dimensional Modeling in Fertility-Preserving Minimally Invasive Gynecologic Surgery: A Scoping Review with Narrative Synthesis

Background and Objectives: Augmented reality (AR), mixed reality (MR), computer vision, artificial intelligence (AI), and three-dimensional (3D) modeling may be particularly relevant in fertility-preserving gynecologic surgery, where disease must be treated while uterine architecture, reproductive anatomy, and future fertility potential are preserved. This scoping review mapped and appraised the current evidence, with emphasis on myomectomy, adenomyomectomy, and endometriosis surgery. Materials and Methods: A scoping review with narrative synthesis was conducted and reported according to the PRISMA Extension for Scoping Reviews (PRISMA-ScR). PubMed/MEDLINE, Scopus, and Google Scholar were searched from database inception to 16 May 2026. Records were appraised with design-appropriate instruments: Joanna Briggs Institute (JBI) principles, Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I), randomized-trial risk-of-bias domains, and structured feasibility criteria. Results: Of 528 records identified, 20 were included. Eleven involved application of the technology in the care of patients; of these, only two were comparative—one retrospective matched case–control study of AR-assisted myomectomy and adenomyomectomy, and one single-center randomized controlled trial of 3D-printed model-assisted myomectomy. The remaining nine were enabling technologies validated on image datasets, operative video, ex vivo models, or animal models. Only one study reported a reproductive outcome—pregnancy rates in a retrospective matched series of 34 patients, which did not differ between groups—and no study reported live birth, obstetric, or long-term reproductive-safety outcomes. Conclusions: Current evidence supports technical feasibility and preoperative planning value but does not demonstrate improvement in reproductive outcomes; here “fertility-preserving” denotes the clinical context of the surgery rather than a demonstrated reproductive benefit. Adequately powered controlled studies reporting fertility-relevant endpoints are required.