Search Results (501)

Introduction: Digital surgical planning in craniomaxillofacial (CMF) surgery requires biomedical engineers who can navigate complex 3D anatomical data confidently, yet most engineering training programmes still rely on static 2D methods. This study evaluated the usability, cognitive demands, and perceived educational outcomes of a clinically derived virtual reality (VR) surgical planning platform for master’s-level biomedical engineering students. Methods: A cross-sectional feasibility study was conducted assessing usability with the System Usability Scale (SUS), cognitive load with a modified NASA Task Load Index (NASA-TLX), and perceived educational outcomes using domain-specific rating scales, with open-ended responses analysed thematically. Results: Twelve of 15 enrolled students completed the survey (80% response rate). The platform achieved a mean SUS score of 72.5 (Above Average), with comparable scores across prior VR experience levels. All NASA-TLX demand dimensions remained below the scale midpoint. All participants rated VR as more engaging than traditional methods, and 91.7% rated the virtual anatomical models as realistic. Self-reported spatial reasoning benefits were most notable in landmark identification, while outcomes for translating digital-to-surgical planning were more limited. Haptic feedback was the most requested enhancement. Conclusions: VR surgical planning tools appear feasible to integrate into biomedical engineering training. Future studies should incorporate objective outcome measures and comparison groups to establish effectiveness. Full article

Background/Objectives: Artificial intelligence (AI) is increasingly being integrated into vascular surgery, particularly in diagnostic imaging, perioperative planning, intraoperative guidance, and postoperative surveillance. This literature review evaluates the current applications of artificial intelligence in vascular surgery and endovascular practice, with a particular focus on imaging technologies and their role in improving diagnostic precision, workflow efficiency, and patient outcomes. In addition, the review examines emerging AI applications in operative workflow optimization, endovascular navigation, postoperative surveillance, training platforms, and AI-assisted clinical decision support. Methods: A literature review was conducted using PubMed and Scopus with the search terms: (artificial intelligence OR AI OR neural network) AND (vascular surgery) AND (diagnosis OR treatment). Reference lists of included studies were manually screened, and additional recent studies were identified from relevant journals. Articles published in English up to April 2026 were included. Studies were assessed for their applications in vascular diagnostics, plaque characterization, endovascular workflow optimization, and postoperative surveillance. Results: AI demonstrated strong diagnostic performance across multiple imaging modalities. Deep learning systems achieved a sensitivity of 91.3% and specificity of 95.2% in peripheral arterial stenosis classification, while plaque characterization models showed accuracies up to 96% and substantial agreement with expert imaging interpretation. AI-assisted operative systems improved procedural efficiency through reductions in operative duration, radiation exposure, and contrast utilization. However, many studies were retrospective, single-center, and based on relatively small cohorts with heterogeneous endpoints. Conclusions: AI has significant potential to improve vascular surgical practice through enhanced image interpretation, procedural guidance, and individualized treatment planning. Despite promising outcomes, current evidence remains limited by methodological heterogeneity and insufficient external validation. Prospective multicenter studies and standardized evaluation frameworks are required before widespread clinical implementation can be achieved. Full article

Accurate monocular depth estimation (MDE) is a foundational task in endoscopic surgery, critical for augmenting depth perception and aiding surgical navigation. While diffusion-based and discriminative depth estimators demonstrate complementary strengths, they also exhibit asymmetric errors: discriminative models yield precise geometric boundaries but struggle in homogeneous or saturated areas, whereas diffusion models recover fine textures at the cost of occasional structural incoherence. To systematically exploit this complementarity, we present CoDepth, a novel framework that leverages confidence-guided fusion to harmonize the outputs of these heterogeneous estimators. Its core components include a complementary map extractor that identifies structured disparity disagreements, a cross-attention module for context-aware feature integration, and a probabilistic confidence network that generates spatially adaptive fusion weights. Extensive evaluations on the SCARED dataset show that CoDepth achieves improved overall performance relative to strong single-model baselines, with the most consistent gains observed in Abs Rel and $\delta$-based accuracy, while changes in some other error metrics are more modest. Furthermore, CoDepth exhibits encouraging cross-domain generalization. When a model trained on SCARED is directly evaluated on SERV-CT, Hamlyn, and C3VD without fine-tuning, it achieves competitive performance and improves several key metrics across datasets. The framework also demonstrates enhanced robustness against common synthetic corruptions like low-light conditions, Gaussian noise, and impulse noise, underscoring its practical utility in complex clinical settings. These results suggest that confidence-guided complementary fusion provides a practical integration-level paradigm for combining heterogeneous endoscopic depth estimators. Full article

Background: Precise intraoperative localisation of small colorectal tumours during laparoscopic surgery remains challenging due to absent tactile feedback and subserosal tumour location. Current standard methods, particularly India ink tattooing, demonstrate 15–30% failure rates for lesions less than 10 mm, leading to prolonged operative times, incomplete resections, and re-operations. Multiple emerging technologies promise improved localisation, yet comparative evidence remains fragmented. Objective: To map and characterise the current landscape of intraoperative marking and identification technologies for small colorectal tumour localisation during laparoscopic surgery, with emphasis on radiofrequency-based methods and alternative approaches, and to identify evidence gaps guiding future research. Methods: Following PRISMA-ScR guidelines, we systematically searched PubMed, Web of Science, and Scopus databases from January 2000 through December 2025 for studies evaluating tumour localisation technologies in colorectal cancer surgery, including primary tumour localisation during laparoscopic colectomy and localisation of colorectal liver metastases during hepatic surgery, or transferable anatomical applications with documented translational potential to colorectal surgery. Two independent reviewers screened all records, with discrepancies resolved through discussion and a third senior reviewer consulted for unresolved disagreements; data were extracted on technical performance, safety, feasibility, cost-effectiveness, usability, innovation potential, and evidence quality. Results: We included 89 studies comprising 18 colorectal-specific articles and 71 transferable/GI-adjacent studies. Detection success rates ranged from 71% to 100% across modalities. Near-infrared fluorescence with indocyanine green demonstrated the strongest clinical evidence with 75–100% detection across eight colorectal studies encompassing 2134 procedures and seamless workflow integration. Radiofrequency identification systems achieved 91.9–99% detection in feasibility studies with promising tissue penetration of 15–35 mm but limited colorectal validation. Electromagnetic navigation excelled in rigid organs with 85–98% success but showed degraded performance in mobile bowel at 71–75%. Critical evidence gaps included absent head-to-head comparative trials, non-standardised outcome metrics limiting cross-study comparability, and limited long-term safety data with only 14 studies providing follow-up exceeding six months. Conclusions: ICG fluorescence represents the most clinically mature technology identified, representing a priority candidate for colorectal-specific validation in challenging localisation scenarios. RFID systems demonstrate promising characteristics justifying prioritised research investment through adequately powered comparative trials. Future research must emphasise consortium-based comparative effectiveness studies, standardised outcome metrics, and integration with robotic and AI-assisted surgical platforms to accelerate clinical translation. Full article

As thoracic surgeons more frequently address smaller lung lesions and perform lung-sparing resections, their objective is to resect an adequate specimen and margin without removing excess healthy lung tissue. Although perioperative lung nodule localization has been in practice for decades, the existing and emerging techniques used for the identification of targeted and occult lesions are more widely utilized today than they were in the past. In this review, we detail the logic behind this increase in use, classify the techniques into preoperative and intraoperative categories, and define the specific modalities available. Where applicable, we review the published data comparing techniques, detailing efficacy and safety. In the preoperative space, we describe standard computed tomography (CT)-guided localization, virtual-assisted lung mapping, electromagnetic navigation bronchoscopy, robotic-assisted bronchoscopy, and novel fiducial markers. In the intraoperative space, we describe classical localization techniques, novel applications of intraoperative cone-beam CT, and fluorescence-guided surgery and intraoperative molecular imaging (IMI). Lastly, we review emerging approaches for intraoperative molecular imaging including a report on agents in early-stage clinical trials and a brief survey of promising preclinical models. With each approach mentioned, we analyze the potential benefits and hazards, and appraise the evidence for (or against) the use of any specific modality. Full article

The adoption of neoadjuvant immune checkpoint inhibitor (ICI)-based chemoimmunotherapy has fundamentally transformed the operative landscape of resectable non-small cell lung cancer (NSCLC). Surgeons are now routinely confronted with ICI-altered tissue planes characterized by hilar fibrosis, vascular friability, and disrupted lymph node architecture. Simultaneously, robotic-assisted thoracic surgery (RATS) has consolidated its position as the dominant minimally invasive platform for pulmonary resection, accounting for the majority of lobectomies and segmentectomies performed at high-volume centers in 2023. Whether RATS confers specific technical advantages in this increasingly complex operative context remains incompletely characterized. We conducted a structured narrative review of published evidence, synthesizing data from randomized controlled trials, prospective cohorts, national registry analyses, and emerging technology reports addressing RATS in the setting of neoadjuvant ICI-based therapy for NSCLC. A systematic literature search was conducted across PubMed and EMBASE using predefined search terms. Available evidence, though largely retrospective and limited by small sample sizes, consistently demonstrates that RATS after neoadjuvant chemoimmunotherapy is technically feasible and oncologically sound, with R0 resection achievable in virtually all cases. The enhanced three-dimensional visualization, tremor filtration, and instrument degrees of freedom afforded by robotic platforms appear particularly advantageous in the setting of dense hilar adhesions and fragile pulmonary vasculature. Lymph node yield, a recognized robotic advantage, is preserved or enhanced despite post-ICI fibrosis. Pooled conversion rates to thoracotomy, derived from post hoc surgical analyses of ICI trial populations rather than trials designed to measure conversion, are higher than for upfront resection; available retrospective single-center data, including one direct RATS-versus-VATS comparison, suggest lower conversion rates with RATS in experienced hands, though this conclusion requires prospective validation. Emerging platform integrations, including combined robotic bronchoscopy and thoracoscopic surgery, single-port systems, and artificial intelligence-assisted anatomical navigation, are poised to further extend the reach of minimally invasive surgery in this challenging clinical scenario. In experienced centers, RATS appears to offer a technically favorable minimally invasive platform for pulmonary resection after neoadjuvant ICI-based therapy, with potential advantages over VATS in managing immunotherapy-altered anatomy; however, this conclusion is derived from retrospective series and should be interpreted cautiously pending prospective comparative data. Prospective multicenter trials with standardized surgical endpoints are urgently needed. Full article

Background: Robotic-assisted bronchoscopy enables precise navigation to peripheral pulmonary lesions and expands minimally invasive diagnostic options in thoracic surgery. At our institution, the ION™ Endoluminal System (Intuitive Surgical, Sunnyvale, CA, USA) was introduced to improve diagnostic accuracy in challenging peripheral targets. It is widely recognized that a defined number of procedures is required to achieve procedural proficiency and optimal clinical outcomes when adopting a novel platform. Therefore, this retrospective single-center study aimed to evaluate the learning curve associated with the implementation of this technology in a thoracic surgery center. Methods: In this retrospective study, all consecutive patients who underwent robotic-assisted bronchoscopies performed using the ION™ Endoluminal System (Intuitive Surgical, Sunnyvale, CA, USA) for the diagnosis of peripheral pulmonary lesions between August 2024 and March 2026 were analyzed. A total of 128 lesions in 89 patients were initially identified. Cases involving marker placement without diagnostic biopsy, as well as procedures not performed by the primary operator, were excluded. After applying exclusion criteria, 109 procedures in 76 patients were included. The mean patient age was 65.4 ± 9.1 years, and 44 patients were female (57.9%). To assess the learning curve, procedures were chronologically divided into three groups: early (cases 1–36), intermediate (37–73), and late (74–109). Outcome measures included procedure time, number of biopsies per lesion, tumor size, and diagnostic yield. Group comparisons were performed using non-parametric and chi-square tests. Procedural learning was assessed by cumulative sum (CUSUM) analysis of procedure time. Results: The overall diagnostic yield was 85.3% (93/109). The diagnostic yield increased over time from 73.0% in the early phase to 83.3% in the intermediate phase and 94.6% in the late phase. The overall comparison was statistically insignificant (χ² p = 0.117); however, there was a significant linear trend across phases, indicating progressive improvement with exposure to the application of this technology. Procedure time decreased significantly from a median of 49.0 min in the early phase to 31.0 min in the intermediate phase and 30.0 min in the late phase (p < 0.001). At the same time, the number of biopsies per lesion increased significantly (p < 0.001). Tumor size did not differ significantly between groups (p = 0.170). Conclusions: Robotic-assisted bronchoscopy demonstrates a clear learning curve, characterized by increasing diagnostic yield and significantly reduced procedure time during the implementation phase. The technique can be effectively integrated into the thoracic surgical diagnostic workflow and represents a valuable addition to minimally invasive diagnostics for peripheral pulmonary lesions. Full article

Robotic assistance in minimally invasive surgery has significantly improved precision and dexterity; however, many supportive tasks, such as blood aspiration, still rely on manual operation. This work presents the design and implementation of a supervised autonomous robotic aspirator for detecting and removing bleeding in an in vitro experimental model. The proposed system integrates a perception module based on a convolutional neural network for real-time blood segmentation, a task planner for high-level action execution, and a control strategy based on artificial potential fields for autonomous navigation. Additionally, a mixed-reality human–robot interaction interface is incorporated to enable system supervision and seamless transition to teleoperation when required. The system was experimentally validated with a set of in vitro experiments under three representative bleeding scenarios, evaluating four suction strategies based on the computation method for the target selection. Results demonstrate high blood removal rates (above 80% in all cases) and high suction efficiency. The comparative analysis reveals that the performance of the suction strategies is scenario-dependent and highlights a trade-off between suction efficiency and removed area. These findings support the feasibility of autonomous robotic aspiration and provide insights into the design of adaptive strategies for surgical assistance, contributing toward increased task autonomy and reduced need for continuous manual suction control during minimally invasive procedures. Full article

Objective: To describe the surgical technique and early clinical outcomes of prone-transpsoas single-position corpectomy (PTP-corpectomy) for the management of complex thoracolumbar spinal pathology. Background: PTP-corpectomy is an emerging technique for providing simultaneous lateral and posterior spinal access without patient repositioning. The previous literature describes the PTP approach for interbody fusions; however, evaluation of its use for corpectomy is limited. This case series reports our experience with the PTP-corpectomy procedure at our institution. Methods: We retrospectively reviewed seven patients who underwent PTP-corpectomy surgery for complex spinal pathologies, including severe kyphoscoliosis, traumatic burst fractures, and revision in 2022–2025. Collected variables included demographics, comorbidities, surgical history, perioperative details, radiographic imaging, and clinical outcomes. Results: All seven patients successfully underwent PTP-corpectomy. The average operative time was 460.6 ± 147.1 min, and the estimated blood loss (EBL) was 892.9 ± 898.3 mL. Average length of stay (LOS) postoperatively was 6.7 ± 3.0 days. One case required revision of a preexisting construct and complex wound closure with plastic surgery, which had significantly increased operative time and blood loss (767 min, 2700 mL). Excluding this complicated case, the average time was 409 ± 63.7 min, and EBL was 591.7 ± 454.3 mL. All seven patients maintained clinical stability postoperatively, demonstrating improvements in pain and functional status at latest follow-up. Follow-up time ranged from 41 to 375 days. Conclusions: Our experience adds to the limited body of evidence that the PTP approach is well suited for corpectomy procedures, and that it is feasible, safe, and effective at improving clinical outcomes for complex spinal pathologies. This series adds to the limited case volume describing this technique in the current literature. Future studies with larger patient populations are warranted to further validate these findings. Full article

Background: Fractures of the upper cervical spine are challenging to treat due to their proximity to critical neurovascular structures and the need for immediate, stable fixation. Open posterior fixation remains the standard but is associated with soft-tissue disruption and morbidity. Minimally invasive, navigation-assisted pedicle screw fixation represents a viable alternative for older populations, significantly reducing surgical morbidity and tissue trauma. The present study evaluates the accuracy, safety, and perioperative outcomes of minimally invasive navigated posterolateral C1–C2 fixation. Methods: We conducted a retrospective consecutive case review of 51 patients who underwent minimally invasive C1–C2 screw fixation between 2019 and 2024. All procedures were performed using intraoperative O-arm imaging and StealthStation S8 navigation. Screw placement accuracy was assessed using the Bredow modification of the Gertzbein–Robbins and Heary classifications. Perioperative data, including operative time, screw dimensions, radiation dose, complications, and hospital stay, were recorded. Results: Fifty-one patients were included in the study. A total of 212 screws were placed. According to Gertzbein–Robbins grading, 92.4% were Grade A, 6.6% were Grade B, and 1% were Grade C. According to Heary grading, 95% were Grade I and 5% were Grade III. No vertebral artery injuries, new neurological deficits, or intraoperative hardware failures occurred. The mean screw lengths were 33.2 mm (SD = 3.38 mm) (C1) and 32 mm (SD = 4.30 mm) (C2). The mean operative time was 128 min (SD = 52.95 min). The mean radiation dose was 629.16 mGy·cm² (SD = 372.2 mGy·cm²). One superficial wound infection occurred. The median postoperative NRS was 4 (IQR: 4–5). The mean hospital stay was 4.21 (SD = 3.77) days. Conclusions: Our findings demonstrate that the presented approach for C1–C2 fixation is a highly accurate and safe alternative to open posterior fixation for upper cervical fractures. Full article

Minimally invasive spine surgery (MISS) has progressively transformed the management of spinal disorders by reducing soft-tissue disruption, perioperative morbidity, and recovery time while maintaining clinical outcomes comparable to conventional open techniques. Beyond its technical evolution, MISS has increasingly assumed a central role in the treatment of bone-related spinal conditions, including vertebral fractures, degenerative instability, metastatic disease, and osteoporosis-associated pathology. This narrative review provides a comprehensive overview of the evolution of MISS with a specific focus on its interaction with vertebral bone biology, implant stability, and fusion processes. A structured literature search of the PubMed/MEDLINE database was conducted, including English-language studies published between 1980 and June 2025 addressing MISS techniques, enabling technologies, and bone-related clinical outcomes. Current evidence suggests that MISS may preserve paraspinal vascularization and soft tissue integrity, potentially supporting bone healing and fusion, although high-quality comparative data remain limited. The effectiveness of MISS in osteoporotic and metastatic vertebral disease is closely linked to bone quality, implant anchorage, and biomechanical considerations, particularly in the context of pedicle screw fixation and interbody support. Emerging technologies—including navigation, robotics, and artificial intelligence—may enhance accuracy in implant placement and reduce bone-related complications, but robust evidence of long-term benefit is still lacking. Despite its advantages, MISS presents important limitations, including a steep learning curve, increased costs, and uncertain superiority in terms of fusion rates and long-term biomechanical stability. Future research should prioritize high-quality comparative studies focusing on bone healing, implant integration, and patient-specific factors such as bone density. MISS should therefore be interpreted not only as a surgical paradigm shift but as an evolving strategy for optimizing outcomes in bone-related spinal disorders. Full article

Lymph node-to-vein anastomosis (LNVA) is an emerging physiologic treatment for fluid-predominant lymphedema that combines the efficacy of lymphatic bypass with reduced technical complexity. Despite its advantages, LNVA is limited by challenges in identifying suitable lymph nodes and recipient veins. This study evaluated whether three-dimensional stereolithography (SLA) could improve surgical planning, intraoperative navigation, and efficiency in robotic LNVA. A retrospective comparative study was conducted of 29 patients who underwent robotic inguinal LNVA between November 2024 and September 2025. Thirteen procedures were performed using standard robotic LNVA (control group), and sixteen were performed with the addition of SLA-assisted planning and navigation (study group). Patient-specific SLA models were created from contrast-enhanced CT data, segmented into lymph nodes, veins, arteries, and bony landmarks, and printed at 1:1 scale for incision planning and real-time intraoperative reference. Outcome measures included operative time, time to identification of target structures (TITS), surgeon-perceived operative difficulty (SPOD), and early patient-reported outcomes. Mean operative time was similar between groups (171 vs. 161 min), but TITS was significantly shorter with SLA (36 vs. 27 min; p = 0.021). Double LNVA was achieved in 69% of SLA cases compared with 8% of controls, without prolonging operative duration. SPOD was significantly lower in the SLA group (p < 0.001). All anastomoses were patent intraoperatively, and all patients reported symptom relief at one month. Model fabrication required approximately eight hours and averaged $270 per case. Stereolithography enhances robotic LNVA by providing a tangible three-dimensional roadmap that improves intraoperative orientation, reduces identification time, and enables multiple anastomoses without added operative burden. With modest cost and rapid production, SLA makes LNVA more precise, reproducible, and scalable—facilitating wider adoption and serving as a foundation for future outcome-based research. Full article

Thin-slice high-resolution computed tomography (CT) has improved the detection of small pulmonary nodules, increasing the demand for minimally invasive diagnostic and therapeutic resection. While lobectomy with lymph node dissection remains the standard surgical approach for many patients with resectable non-small cell lung cancer, accumulating evidence supports sublobar resection for selected small, peripheral, and ground-glass-dominant lesions when sufficient margins are achievable. In thoracoscopic and robotic surgery, localization of nodules ≤10 mm or lesions located >5 mm from the pleural surface can be challenging, and failure to identify the target may lead to conversion, larger resection than intended, or prolonged operative time. Several localization strategies have been developed, including CT-guided percutaneous wire/coil/dye marking, bronchoscopic dye mapping, and virtual-assisted lung mapping (VAL-MAP), robotic-assisted bronchoscopic dye or fiducial localization, radiofrequency identification microtag systems (Surgical Real-Time FInger Navigation and Detection) that provide real-time depth information, and single-stage intraoperative CT-guided marking and resection in hybrid operating rooms. This review synthesizes representative evidence and published outcome ranges, and compares workflows, marker-to-lesion precision metrics, complication profiles, operational burden, and cost structures. We emphasize the practical contrast between two-stage and single-stage workflows, the access-route differences between transthoracic and transbronchial techniques, and the need to report localization-to-incision “time at risk”. We also present an expert-consensus decision algorithm aimed at facilitating tailored selection of localization strategies for modern minimally invasive thoracic surgery. Full article

Background: Cardiovascular disease remains the leading global cause of morbidity and mortality. Mental health disorders are common comorbidities that significantly influence how patients access and navigate specialist care. Increasingly, mental illness is recognized not merely as a comorbidity but as a potential driver of inequities in cardiovascular care, affecting diagnosis, referral, procedural management, and long-term secondary prevention. These concerns are particularly relevant in cardiac surgery, where care pathways are complex and resource-intensive. Aims and Objectives: This narrative review examines recent evidence on inequalities in access to cardiac surgery and postoperative outcomes among patients with mental health disorders. Particular emphasis is placed on severe mental illness, mood disorders, anxiety-related conditions, and mixed psychiatric cohorts. Materials and Methods: A structured narrative review approach was employed. PubMed and ScienceDirect were systematically searched for peer-reviewed studies published between 2020 and 2025, including cohort studies, registry analyses, systematic reviews, and meta-analyses. The evidence was synthesized thematically, focusing on access to care, perioperative management, clinical outcomes, underlying mechanisms, ethical considerations, policy implications, and future research directions. Results: Evidence suggests that patients with mental health disorders are more likely to undergo cardiac surgery via emergency pathways, experience longer hospital stays, and have higher rates of readmission. Individuals with severe mental illness are less likely to receive invasive coronary procedures compared to the general population and exhibit higher short- and long-term mortality following acute coronary syndromes. Among psychiatric subgroups, psychosis-spectrum disorders appear to be associated with the greatest excess risk of morbidity, mortality, and adverse long-term surgical outcomes. Conclusions: Patients with mental health disorders face inequities across the entire surgical pathway, including preoperative, perioperative, and postoperative phases. Key contributing factors include stigma, diagnostic overshadowing, fragmented healthcare systems, socioeconomic disadvantage, and insufficiently developed models of integrated care. Addressing these disparities requires redesigned referral pathways, strengthened multidisciplinary collaboration (including cardiology, cardiac surgery, psychiatry, and primary care), and a shift toward interventional research aimed at reducing inequities rather than solely documenting them. Full article

Background/Objectives: Transsphenoidal surgery has become the gold standard for the treatment of sellar and parasellar lesions, but it remains associated with significant anatomical challenges and the risk of intraoperative complications. The limitations of conventional imaging in depicting the complex three-dimensional anatomy of the skull base have led to a growing interest in virtual (VR) and augmented reality (AR) technologies, which offer enhanced spatial visualization, preoperative simulation, and image-guided intraoperative navigation. This systematic review aims to evaluate the current evidence on the role of virtual and augmented reality in transsphenoidal surgical interventions, with a focus on their impact on preoperative planning, intraoperative orientation, surgical outcomes, and neurosurgical training. Methods: A systematic literature search was conducted in accordance with PRISMA 2020 guidelines across PubMed, Scopus, and Web of Science for the period 2015–2025. MeSH terms and free-text keywords related to transsphenoidal surgery, sphenoid sinus anatomy, and VR/AR technologies were combined using Boolean operators. Risk of bias was assessed using RoB 2.0 for RCTs; methodological quality was assessed using the Newcastle–Ottawa Scale for observational studies and AMSTAR 2 for systematic reviews. Clinical, morphometric, and experimental studies evaluating VR/AR applications were included. Data were extracted using a standardized protocol and synthesized through qualitative analysis, with subgroup analysis by technology type (VR vs. AR) and clinical application domain. Results: A total of 218 publications were identified, of which 52 met the inclusion criteria (clinical studies n = 12, simulation and technology studies n = 30, morphological studies n = 10). VR-based three-dimensional reconstructions were consistently associated with improved preoperative spatial orientation and anatomical landmark recognition. AR systems demonstrated a meaningful contribution to intraoperative navigation, with reported reductions in time to target and improved visualization of critical neurovascular structures. VR platforms showed high effectiveness in surgical training, with shorter learning curves and improved technical performance. However, the majority of included studies were small observational cohorts, simulation studies, or expert overviews, with substantial heterogeneity in methodology, technology platforms, and outcome measures, precluding quantitative meta-analysis. Conclusions: Virtual and augmented reality represent clinically promising adjuncts to transsphenoidal surgery, with demonstrated benefits in preoperative planning, intraoperative navigation, and surgical training. These conclusions should be interpreted in the context of a predominantly early-phase and heterogeneous evidence base. Standardized protocols, larger prospective studies, and randomized trials are needed before the integration of VR/AR with navigation systems and artificial intelligence can be established as a routine component of personalized transsphenoidal surgery. Full article