The Role of Augmented Reality in Surgical Training: A Narrative Review

Abstract

Augmented reality (AR) is increasingly being integrated into open and laparoscopic surgical education, layering digital guidance onto real-world instruments and tissues to promote safer, more structured skill acquisition. This narrative review synthesizes recent evidence on AR platforms, including video-based overlays, head-mounted displays, and hybrid box-trainer systems, used for basic and advanced tasks, telementoring, and procedural rehearsal. Across surgical specialties, AR-enhanced training consistently improves objective performance metrics, such as task completion times, error rates, and standardized assessment scores (e.g., GOALS/OSATS), compared with conventional methods. It also lowers cognitive workload while enabling standardized feedback and remote expert support. Early integration into robotic surgery training suggests similar benefits in reducing learning curves and enhancing spatial awareness. However, significant barriers persist, including the technical challenge of accurately registering virtual overlays with real anatomy, ergonomic issues and visual fatigue associated with head-mounted displays, and a lack of hardware and software standardization. Furthermore, the evidence base is dominated by small, single-center studies, which limit the generalizability of findings and confirmation of long-term skill transfer to the operating room. Future priorities should focus on developing higher-fidelity haptics, achieving seamless curricular integration, and conducting multicenter randomized trials that track skill retention and patient-centered outcomes. Ultimately, AR serves as a powerful adjunct rather than a replacement for traditional simulation and mentorship, holding substantial potential to broaden access to high-quality surgical training and enhance operator performance.