Image-navigated endoscopic surgery: introduction of the face-mounted display system with picture-in-picture capabilities.

Background/Aims: The face-mounted display system with picture-in-picture capabilities was evaluated for clinical usefulness in endoscopic surgery. Methodology: The device mounts two crystal liquid color panels, being shaped like a pair of glasses. It can provide us with an ultra-large virtual screen of the endoscopic view. Furthermore, a picture-in-picture capability can materialize a multi-image environment. Twenty-five patients were enrolled in this study. Results: The view obtained by the surgeon consisted of the FMD screen of the upper two-thirds and the direct view of the lower one-third. The surgeon could concentrate more on the procedure, because he could face the target organ regardless of the display position. No complications attributable to the device were encountered. With a multi-image environment, endoscopic procedure was executed without taking one's eyes off the operative field. Conclusions: The face-mounted display system will conduct us to another sphere of endoscopic surgery, i.e., an image-navigated endoscopic surgery.