• Pieter W Stark, O J F van Waes, John S Soria van Hoeve, Borger van der BurgBoudewijn L SBLS0000-0002-1199-4042Department of Surgery, Alrijne Hospital, Leiderdorp, South-Holland 2353 GA, the Netherlands., and Rigo Hoencamp.
• Trauma Research Unit, Department of Surgery, Erasmus MC University Hospital, Rotterdam, South-Holland 3015 GD, the Netherlands.
• Mil Med. 2024 Mar 28.

IntroductionThe main goal of this study was to assess the feasibility of a head-mounted display (HMD) providing telemedicine neurosurgical support during a decompressive craniectomy by a military surgeon who is isolated from readily available neurosurgical care. The secondary aim was to assess the usability perceived by the military surgeon and to evaluate technical aspects of the head-mounted display.Materials And MethodsAfter a standard concise lecture, 10 military surgeons performed a decompressive craniectomy on a AnubiFiX-embalmed post-mortem human head. Seven military surgeons used a HMD to receive telemedicine neurosurgical support. In the control group, three military surgeons performed a decompressive craniectomy without guidance. The performance of the decompressive craniectomy was evaluated qualitatively by the supervising neurosurgeon and quantified with the surgeons' operative performance tool. The military surgeons rated the usability of the HMD with the telehealth usability questionnaire.ResultsAll military surgeons performed a decompressive craniectomy adequately directly after a standard concise lecture. The HMD was used to discuss potential errors and reconfirmed essential steps. The military surgeons were very satisfied with the HMD providing telemedicine neurosurgical support. Military surgeons in the control group were faster. The HMD showed no hard technical errors.ConclusionsIt is feasible to provide telemedicine neurosurgical support with a HMD during a decompressive craniectomy performed by a non-neurosurgically trained military surgeon. All military surgeons showed competence in performing a decompressive craniectomy after receiving a standardized concise lecture. The use of a HMD clearly demonstrated the potential to improve the quality of these neurosurgical procedures performed by military surgeons.© Oxford University Press 2024.

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