The da Vinci surgical system (dV), the world's most widely used surgical robot, was connected to the Meta Quest (MQ) virtual reality (VR) headset, the best-selling headset globally. A difference exists in the visual experience between the console surgeon (CS) and the first assistant (FA). While the CS performs robotic surgery using a 3D viewer, the FA provides support viewing a 2D monitor, positioned away from the sterile surgical field. To address this, we tried to connect the MQ headset to the dV system, allowing the FA to use MQ during surgery.

We aimed to evaluate whether MQ could enhance the FA's workflow. With no financial support, we acquired low-cost devices via Amazon and other e-commerce platforms. We connected the DVI port of the dV system to the USB-C port of the MQ headset via a video capture board. To mitigate concerns about time delays associated with Wi-Fi, a wired connection was employed.

While the FA's view remained 2D, the MQ provided a wider screen with high-resolution imagery. Additionally, the MQ's Passthrough feature enabled the FA to support surgery by overlaying endoscopic video onto a real-world view. The hand-tracking functionality allowed the FA to adjust the position and size of the endoscopic video. The wired connection did not hinder the FA's workflow. Although the combined weight of the headset and strap is approximately 1 kg, which was anticipated to cause neck and shoulder strain, the FA primarily reported eye fatigue, similar to CS experiences, rather than stiffness. Using a well-regarded third-party head strap might alleviate such symptoms. The MQ's field of view, which is somewhat restricted like that of binoculars, required the FA to turn their head more frequently. The headset's ability to connect to a browser enabled the FA to perform additional tasks during surgery, such as checking emails, playing music, or looking up information. Regarding patient information security, we confirmed confidentiality by sending a questionnaire to Meta, and the company assured us that the streaming video is securely protected. Based on this experience, we anticipate that if the MQ headset could incorporate a feature for operating electronic medical records, the FA could submit medical orders using hand-tracking within the sterile field.

The integration of MQ with the dV system shows promise in enhancing the assistant's workflow. Further improvements in VR headset technology are anticipated.