Endoscopic Submucosal Dissection Using Head-mounted Display.

© 2015 by the AGA Institute 0016-5085/$36.00 http://dx.doi.org/10.1053/j.gastro.2015.04.056 Eendoscopic technique for en bloc resection of mucosal cancers in the esophagus, stomach, and colon. During the procedure, the ESD operator must concentrate on the endoscopy monitor to avoid complications and to complete the treatment. However, in some situations, it becomes difficult to operate the endoscope during ESD, and the operator may be forced to view the monitor from a difficult posture. When performing ESD, the operator must also monitor the patient’s vital signs carefully. This sometimes requires the operator to turn his or her eyes from the endoscopy monitor to the vital signs monitor. At such times, the operator’s concentration on the endoscopy monitor can be disturbed during ESD. A head-mounted display (HMD) augments the visual world and aids in visual task completion. Some clinical studies have reported that an HMD is useful in laparoscopic surgery. The HMD provides freedom from gazing at a stationary monitor, which improves the surgeon’s ergonomic position. A high-resolution HMD in laparoscopic surgery can offer significantly better image quality and allow faster task performance than an overhead display. We have performed ESD using a high-resolution HMD, which allows us to focus on the endoscopy monitor more easily, and we have evaluated the efficacy of using the HMD in ESD.