title: Use of head-mounted display in transanal endoscopic microsurgery.
abstract: BACKGROUND
  Head-mounted display (HMD) decreases the forced adjustments of position and eyes in endoscopic surgery. During transanal endoscopic microsurgery (TEM), these adjustments might even be greater because of the direct viewing technique. We investigated the feasibility of HMD in TEM.
  
  
  METHODS
  Head-mounted display is a helmet with two built-in displays. The stereoscopic endoscope (with two separate lens systems) provides separate images at each display. During TEM, standard stereoscopic optic and HMD were alternated.
  
  
  RESULTS
  Use of HMD was possible after construction of a special device. The helmet was comfortable to wear, and the peripheral view was adequate. The operator's position was upright and relaxed. The range and depth of vision seemed comparable with those of the standard stereoscopic optic. The quality of the displays in the helmet is limited.
  
  
  CONCLUSIONS
  Head-mounted display is feasible in TEM. It enables a more relaxed position and view on the operative field. The quality of the display in the helmet requires improvement.
authors.affiliation: Department of Surgery, IJsselland Hospital, Prins Constantijnweg 2, 2906 ZC Capelle aan den IJssel, The Netherlands.
authors.forename: J J M
authors.initials: JJ
authors.lastname: van Koesveld
authors.forename: G W M
authors.initials: GW
authors.lastname: Tetteroo
authors.forename: E J R
authors.initials: EJ
authors.lastname: de Graaf
mesh_terms: D018253:Adenoma, Villous / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D003626:Data Display / Q000639:trends; D019723:Endoscopes / Q000639:trends*; D005260:Female; D006257:Head; D006470:Hemorrhage / Q000209:etiology / Q000601:surgery; D006801:Humans; D007413:Intestinal Mucosa / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008866:Microsurgery / Q000295:instrumentation* / Q000379:methods*; D008875:Middle Aged; D009949:Orientation; D011351:Proctoscopy / Q000379:methods*; D012004:Rectal Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D013997:Time Factors; D014463:Ultrasonography; D014584:User-Computer Interface