The Role of Holograms in Medicine: Revolutionizing Surgical Navigation and Beyond

Abstract

Background: Holography provides realistic three-dimensional (3D) visualization, which enhances surgical procedure accuracy and anatomical comprehension. Its clinical utility has increased as a result of its integration with technologies such as augmented reality (AR), computer-generated holography (CGH), and mixed reality (MR).

Objective: To review the use of holography in surgery for training, diagnostics, intraoperative navigation, and planning. Methods: Seventy-seven studies from PubMed, IEEE Xplore, and Google Scholar published between 1981 and 2025 were examined. Clinical trials, technical assessments, simulations, and feasibility studies were among the study types.

Findings: Multiple specialties, including neurosurgery, cardiothoracic surgery, orthopedics, and urology, have used holography. Improved training results, decreased radiation exposure, increased anatomical visualization, and surgical accuracy were among the benefits that were reported. AR platforms, CGH, and MR headsets were frequently utilized.

Conclusion: Holography is developing into a useful surgical instrument that increasingly influences workflow efficiency, safety, and education.

Keywords: Holography; Haptic Feedback; Surgical Navigation; Medical Education; Telemedicine; Hologram; Surgery

Abbreviations: 2D: Two-Dimensional; 3D: Three-Dimensional; AI: Artificial Intelligence; AR: Augmented Reality; CABG: Coronary Artery Bypass Grafting; CGH: Computer-Generated Holography; CT: Computed Tomography; EVD: External Ventricular Drain; FUS: Focused Ultrasound; GI – Gastrointestinal; HMD: Head-Mounted Display; IOL: Intraocular Lens; MR: Mixed Reality; MRI: Magnetic Resonance Imaging; OR: Operating Room; PCNL: Percutaneous Nephrolithotomy; RCT: Randomized Controlled Trial; TKA: Total Knee Arthroplasty; TME: Total Mesorectal Excision; VR: Virtual Reality; XR: Extended Reality (includes AR, MR, and VR)

Introduction

Dennis Gabor first proposed holography in 1948. Holograms are three-dimensional (3D) images created by recording and reconstructing an object’s light field [1]. In contrast to conventional imaging, holography maintains the light’s amplitude and phase, allowing for parallax and depth perception. Usually, a coherent light source, like a laser, records the interference pattern between an object beam and a reference beam to create a hologram [2].

Holograms can be divided into groups according to how they are recorded and reconstructed; each group is designed for a particular technological use. Primarily used in research settings, transmission holograms are created by overlapping coherent reference and object beams on photosensitive media. They are then reconstructed for high-fidelity imaging under laser illumination [3]. Conversely, reflection (Denisyuk) holograms, which function under white-light illumination, are widely used for display and educational purposes [4]. Volume or Bragg holograms exploit thick recording materials to achieve strong angular and spectral selectivity, making them suitable for data storage and optical filtering [5].

Computer-generated holography (CGH), a more recent development, uses sophisticated micro-printing techniques or spatial light modulators to encode wavefronts for digital display after simulating them algorithmically. Both software and hardware in this field have advanced significantly [6]. Because of their visual impact and ease of manufacturing, specialized variations such as multiplexed or embossed holograms and rainbow holograms—which are optimized for color viewing—are also frequently utilized in security applications [7,8].

Holography is based on the laws of diffraction and interference in physics. Coherence, beam geometry, and recording medium characteristics are just a few variables affecting image reconstruction fidelity [8]. With digital holography, these optical principles are integrated with computational methods to reconstruct the object wavefront using software. These digital approaches are increasingly central to modern mixed reality systems—such as Microsoft HoloLens— which blend virtual models with the real world [9].

Outside of medicine, holography has already seen wide applications in data storage, quality inspection, product authentication, and immersive display technology [9]. In the medical field, its most significant value lies in how it allows clinicians to visualize complex spatial relationships non-invasively. As a result, it is being adopted in anatomy education, radiology, preoperative planning, and, more recently, real-time surgical guidance [10,11].

In surgery, holography is gaining traction as an intraoperative tool. Using systems like the HoloLens, surgeons can project 3D, patient- specific models into the operative field, offering intuitive anatomical reference points without needing to glance at 2D screens [11]. Some studies have shown that these augmented reality (AR) systems can achieve sub-2 mm accuracy in surgical navigation, suggesting they may soon have routine clinical value [12].

Parallel to advances in holography, other emerging technologies are reshaping clinical practice. For example, the integration of artificial intelligence into auscultation has transformed a centuries- old bedside skill. Digital and AI-assisted stethoscopes have demonstrated improved diagnostic accuracy, reduced inter-observer variability, and enabled telemedicine applications, bridging the gap between traditional examination and modern digital medicine [9]. Similarly, the concept of the “Internet of Orthopaedic Things (IOT)” extends the Internet of Medical Things into the orthopedic domain, combining implants, wearable sensors, and mobile applications to provide real-time monitoring, personalized treatment, and remote rehabilitation. These systems have the potential to revolutionize orthopedic healthcare delivery by enabling continuous patient-specific data collection and feedback [7].

Together, these developments illustrate how digital health tools—whether AI-enhanced diagnostics, IoT-driven monitoring, or holographic visualization—are converging toward more personalized, precise, and accessible models of care.

This review aims to bridge the gap between engineering and clinical literature. By synthesizing recent technological and clinical developments, we hope to offer a comprehensive overview of how holography is being integrated into surgical practice and how it may transform medicine in the years to come.

Methods

This paper extracted data from 77 studies discussing the applications of holograms in surgery, spanning many academic databases - including PubMed (59 studies), IEEE Xplore (14 studies), and Google Scholar (4 studies) and generally across 1981 and 2025. The studies were of different designs, including feasibility studies, case reports, randomized controlled trials (RCTs), preclinical validations, user evaluations, and technical developments. The application of holograms in each paper employed a wide range of technologies, from mixed reality (MR) and other head-mounted displays (HMDs) to computer-generated holography (CGH) and acoustic and interferometric holograms.

These applications proved to be impactful in different surgical subspecialties, including cardiothoracic, general surgery, neurosurgery, orthopedics, ophthalmology, and many more. They have also shown potential in aiding different surgical procedures (diagnostic and therapeutic), including radiology (ultrasonography, fluoroscopy) and endoscopy. Data were extracted from each study’s structured summary and applications were recorded with attention to holography’s effect on procedural safety, anatomical visualization, surgical accuracy, cognitive workload, and education.

No meta-analysis was performed. Instead, trends were qualitatively analyzed, and outcomes were compared within and across specialties to identify common benefits and limitations of holographic implementation (Table 1).

Table 1: Overview of 77 Studies Assessing the Clinical Uses of Holography in Various Surgical Specialties (1981–2025)

This table presents a structured overview of publications on holography in surgical settings. A thorough examination of holography’s function in contemporary surgery is supported by the data, which are arranged by specialty and cover both experimental and clinical applications.

Discussion

Part 1: Neurosurgery

Holography in neurosurgery has been applied in tumor resection, catheter placement, neuronavigation, and training. Studies by [12-14] showed improved spatial orientation and operative accuracy using CT/MRI-derived holograms. [14] and [13]. (2024) tested holographic neuronavigation systems with acceptable anatomical alignment but highlighted ongoing limitations in precision.

Tool-tracking [15] and autonomous planning systems [16] enhanced accuracy for novices. [17] and [18] contributed early data on holographic overlays during skull base surgery. [11] used holography for stereotactic targeting. [15] developed holographic temporal bone dissections, expanding its utility in training.

Summary

i. Enhances intraoperative navigation, especially for lesions and shunts ii. Supports simulation and cadaveric training iii. Demonstrates improved novice accuracy with tool-tracking MR iv. Needs refinement in precision for routine intraoperative use

Part 2: Cardiac and Cardiothoracic Surgery

MR holography was used to diagnose and plan congenital and structural heart disease surgeries [18-20]. Real-time overlays [21,22] improved CABG planning. [23]. (2025) demonstrated intraoperative benefits in minimally invasive valve surgeries, and [24] applied holography to fluid-dynamic modeling in aortic dissection.

Simulators like [25] improved mitral valve training. [26,27] validated echo-based and intraprocedural 3D holograms. [26] used holography for prosthetic valve evaluation.

Summary

i. Improves preoperative modeling and valve planning ii. Effective in minimally invasive cardiac navigation iii. Supports simulation-based education iv. Aids hemodynamic modeling and device validation

Part 3: Thoracic Surgery

Holography facilitated segmentectomy planning [21], bronchovascular visualization [19], and thoracoscopic navigation [28]. demonstrated its value in tumor boards. Sugimoto and Sueyoshi (2023) applied their MR system in over 400 cases, including thoracic and GI surgeries.

Summary

i. Assists lung segment localization and vascular navigation ii. Enables tumor board planning and team communication iii. Offers hands-free MR controls intraoperatively iv. Reduces uncertainty in minimally invasive thoracic surgery

Part 4: Colorectal and General Surge

Holography improved intraoperative orientation in colorectal surgery [29, 30, 31]. and emphasized its training value. [32] and [33] applied holography in liver surgery. [34] automated liver segment mapping. [23,24] used holography in gallbladder surgery, while [26]. explored its use in pancreatic resections.

Summary

i. Improves colorectal and hepatic navigation ii. Enhances anatomical confidence in pelvic dissections iii. Offers education/simulation value for trainees iv. Applies to gallbladder, gastric, and pancreatic surgery

Part 5: Urology

Preoperative planning for nephron-sparing surgery was improved by holography in studies by [35,36]., showing altered surgical strategies and increased confidence. [37] introduced intraoperative MR-guided kidney puncture, resulting in higher accuracy and lower radiation exposure. [38] integrated robotic systems with holography for enhanced needle placement. Although cardiac-focused, [25] highlighted a cross-applicable simulation platform adaptable to urologic surgery.

Summary

i. Enhances renal surgery planning and operative decisions ii. Supports fluoro-free PCNL access with holographic guidance iii. Enables robot-hologram integration for needle alignment iv. Extends to simulated training in endourology and reconstruction

Part 6: Orthopedic Surgery

[39, 11] demonstrated holography for intraoperative alignment and navigation in orthopedic fixation, showing promising but imperfect accuracy. [40]. (2025)’s meta-analysis confirmed improved performance among novices using holographic systems.

Simulation studies [41, 42] validated MR in orthopedic education, showing better performance, reduced workload, and improved engagement. [6] applied MR to iliosacral screw guidance.

Summary

i. Improves implant positioning and anatomic navigation ii. Validates simulation-based training with objective metrics iii. Reduces radiation and errors among junior surgeons iv. Applies to both elective and trauma orthopedics

Part 7: Ophthalmology

[43,44] created MR simulators for IOL selection, improving patient decision-making and alignment with outcomes. [45] demonstrated early CGH and interferometry applications in corneal surgery and stress mapping. [23] introduced custom diffractive holographic lenses. [46] used optogenetic holography in vision restoration models.

Summary

i. Improves IOL selection and pre-op education ii. Applies CGH in corneal trephination iii. Enables customized visual correction iv. Supports vision restoration research with holographic stimulation

Part 8: ENT and Skull Base Surgery

MR was used for endoscopic tumor excision [47] and sinus navigation [48,49]. developed an MR dissection platform for the temporal bone. [50,51,52], showed MR’s value in soft-tissue facial planning, improving symmetry and marking precision.

Summary

i. Aids navigation in skull base and sinus surgery ii. Enables training in temporal bone anatomy iii. Improves aesthetic planning and surgical markings iv. Demonstrates strong application in both functional and cosmetic ENT surgery

Part 9: Plastic and Reconstructive Surgery

[53] reduced costs and increased accuracy in face transplant planning by utilizing 3D printing and MR. Soft-tissue holographic facial navigation was validated by [50]. In order to improve surgical symmetry, [51] employed holographic overlays for facial markings.

[52] developed holographic models for midface deformities using CT/MRI. In order to cut down on fluoroscopy and operating time, [54] employed MR in craniofacial osteotomies.

Summary

i. Enhances facial symmetry, marking, and alignment ii. Improves craniofacial planning and reduces intra-op time iii. Supports team-based planning for complex reconstructions iv. Useful in both aesthetic and congenital surgery

Part 10: Gynecology and Urogynecology

[55] developed a pelvic floor holographic simulator for mid-urethral sling and prolapse procedures. It improved anatomical understanding and surgeon confidence. [25] also showed simulator adaptability to gynecologic contexts. Although gynecology-specific intraoperative applications remain limited, [56] suggested that holography could improve patient education.

Summary

i. Supports MR-based simulation for pelvic surgery ii. Enhances education and spatial orientation in residents iii. Offers potential for patient counseling tools iv. Applications in emerging complex gynecologic reconstruction

Part 11: Miscellaneous and Experimental Applications

[57] used CGH to steer focused ultrasound beams around obstacles. [58,59] expanded acoustic holography for uniform tissue ablation. [46, 89, 90] applied holographic light stimulation in optogenetic vision restoration.

[23] developed diffractive holographic lenses for refractive correction. [22] used holograms in tumor boards for thoracic oncology to support multidisciplinary collaboration.

Summary

i. Enables acoustic holography for non-invasive lesion ablation ii. Applies to cortical prosthetics and vision neuroscience iii. Supports holographic tumor boards for collaborative planning iv. Shows growing use in therapeutics and diagnostics Across all surgical domains, holography demonstrated: i. Enhanced 3D visualization and anatomical understanding in complex procedures ii. Improved surgical precision, planning, and spatial confidence intraoperatively iii. Training and simulation value, especially for junior surgeons iv. Workflow integration, including robotic systems, tool tracking, and MR controls v. Broader impact on patient education, team communication, and even lesion targeting

Holography is not just a visual aid—it is becoming a core surgical tool with expanding roles in navigation, education, collaboration, and, potentially, non-invasive therapy.

Conclusion

Holography is gradually changing from a cutting-edge imaging method to a valuable and adaptable surgical instrument. It can guide complex neurosurgical and cardiovascular procedures, improve orthopedic training, and educate patients in ophthalmology, as demonstrated by the seventy-seven reviewed studies. Anatomical visualization, surgical accuracy, intraoperative orientation, and learning outcomes have all been shown to improve with these technologies regularly.

Even though many existing systems are still under development or have only been used in feasibility studies, mounting evidence is that they can be integrated into everyday workflows. Surgeons report more spatial awareness, trainees gain from realistic simulations, and patient-specific holograms help provide more individualized and accurate care. Holography has also demonstrated promise in lowering radiation exposure, cognitive load, and operating time in specific procedures.

Issues are still mainly related to the adoption learning curve, registration accuracy, system standardization, and cost. However, many of these obstacles are being addressed by engineering advancements, and their value is being confirmed by the clinical literature more and more.

Holographic systems will probably be used more frequently in surgical planning, execution, and instruction as they advance in sophistication, accessibility, and integration with other technologies, such as robotic platforms and artificial intelligence. This review encourages more research and interdisciplinary cooperation to fully realize holography’s potential as a game-changing tool in contemporary surgical practice.

Acknowledgements

The authors wish to acknowledge the contributions of researchers and institutions whose work has been instrumental in advancing the field of holographic technologies in medicine. This review was supervised by Dr. Muhammad Iftikhar Hanif, Newcastle University Medicine Malaysia (NUMed), Johor, Malaysia, whose guidance and support were invaluable throughout the research and writing process.

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