Telepresence for surgical assistance and training using eXtended reality during and after pandemic periods

Eric L. Wisotzky*, Jean Claude Rosenthal, Senna Meij, J.J. van den Dobbelsteen, Philipp Arens, Anna Hilsmann, Peter Eisert, Florian Cornelius Uecker, Armin Schneider

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

1 Citation (Scopus)
93 Downloads (Pure)


Existing challenges in surgical education (See one, do one, teach one) as well as the COVID-19 pandemic make it necessary to develop new ways for surgical training. Therefore, this work describes the implementation of a scalable remote solution called “TeleSTAR” using immersive, interactive and augmented reality elements which enhances surgical training in the operating room. The system uses a full digital surgical microscope in the context of Ear–Nose–Throat surgery. The microscope is equipped with a modular software augmented reality interface consisting an interactive annotation mode to mark anatomical landmarks using a touch device, an experimental intraoperative image-based stereo-spectral algorithm unit to measure anatomical details and highlight tissue characteristics. The new educational tool was evaluated and tested during the broadcast of three live XR-based three-dimensional cochlear implant surgeries. The system was able to scale to five different remote locations in parallel with low latency and offering a separate two-dimensional YouTube stream with a higher latency. In total more than 150 persons were trained including healthcare professionals, biomedical engineers and medical students.

Original languageEnglish
Number of pages15
JournalJournal of Telemedicine and Telecare
Publication statusPublished - 2023


  • annotations
  • ear–nose–throat
  • live streaming
  • mixed reality
  • pandemic
  • surgical training
  • telehealth
  • Telepresence


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