title: New head-mounted display system applied to endoscopic management of upper urinary tract carcinomas.
abstract: OBJECTIVE
  We tested a new head-mounted display (HMD) system for surgery on the upper urinary tract.
  
  
  METHODS
  Four women and one man with abnormal findings in the renal pelvis on computed tomography and magnetic resonance imaging underwent surgery using this new system. A high definition HMD (Sony, Tokyo, Japan) is connected to a flexible ureteroscope (Olympus, Tokyo, Japan) and the images from the ureteroscope are delivered simultaneously to various participants wearing HMDs. Furthermore, various information in addition to that available through the endoscope, such as the narrow band image, the fluoroscope, input from a video camera mounted on the lead surgeon's HMD and the vital monitors can be viewed on each HMD.
  
  
  RESULTS
  Median operative duration and anesthesia time were 53 and 111 minutes, respectively. The ureteroscopic procedures were successfully performed in all cases. There were no notable negative outcomes or incidents (Clavien-Dindo grade ≥ 1).
  
  
  CONCLUSIONS
  The HMD system offers simultaneous, high-quality magnified imagery in front of the eyes, regardless of head position, to those participating in the endoscopic procedures. This affordable display system also provides various forms of information related to examinations and operations while allowing direct vision and navigated vision.
authors.affiliation: Department of Urology, Tokyo Medical and Dental University Graduate School, 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan.
authors.forename: Junichiro
authors.initials: J
authors.lastname: Ishioka
authors.affiliation: Department of Urology, Tokyo Medical and Dental University Graduate School, 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Kihara
authors.affiliation: Department of Urology, Tokyo Medical and Dental University Graduate School, 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan.
authors.forename: Saori
authors.initials: S
authors.lastname: Higuchi
authors.affiliation: Department of Urology, Tokyo Medical and Dental University Graduate School, 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Nakayama
authors.affiliation: Department of Urology, Tokyo Medical and Dental University Graduate School, 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Takeshita
authors.affiliation: Department of Urology, Tokyo Medical and Dental University Graduate School, 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Yoshida
authors.affiliation: Department of Urology, Tokyo Medical and Dental University Graduate School, 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan.
authors.forename: Yasukazu
authors.initials: Y
authors.lastname: Nakanishi
authors.affiliation: Department of Urology, Tokyo Medical and Dental University Graduate School, 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan.
authors.forename: Toshiki
authors.initials: T
authors.lastname: Kijima
authors.affiliation: Department of Urology, Tokyo Medical and Dental University Graduate School, 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan.
authors.forename: Yoh
authors.initials: Y
authors.lastname: Matsuoka
authors.affiliation: Department of Urology, Tokyo Medical and Dental University Graduate School, 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan.
authors.forename: Noboru
authors.initials: N
authors.lastname: Numao
authors.affiliation: Department of Urology, Tokyo Medical and Dental University Graduate School, 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan.
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Saito
authors.affiliation: Department of Urology, Tokyo Medical and Dental University Graduate School, 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan.
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Fujii
mesh_terms: D000368:Aged; D001706:Biopsy; D002277:Carcinoma / Q000473:pathology / Q000601:surgery*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D015203:Reproducibility of Results; D016896:Treatment Outcome; D020709:Ureteroscopes; D018666:Ureteroscopy / Q000295:instrumentation / Q000379:methods*; D014551:Urinary Tract / Q000601:surgery; D014571:Urologic Neoplasms / Q000473:pathology / Q000601:surgery*; D020535:Video-Assisted Surgery / Q000295:instrumentation / Q000379:methods*