Study Evaluating the Ergonomic Benefits of Head-Mounted Display in Spine Surgery

In neurosurgery, operating microscopes are indispensable, albeit associated with ergonomic challenges impacting surgeons' posture and potentially leading to musculoskeletal disorders. A recent study conducted by the team at Department of Neurosurgery at the Medical University of Innsbruck (Director Prof. Claudius Thomé) investigated the use of the RoboticScope with its Head-Mounted Display (HMD) in spine surgery. Published in January 2024, their work focuses on the ergonomic benefits and performance outcomes of this technology. (Demetz et al., 2024) 

Enhanced Ergonomics of the RoboticScope

With the RoboticScope, surgeons are detached from the microscope and the Head-Mounted Display provides the image of the surgical site directly in front of their eyes. Surgeons can freely choose to sit, stand or move between positions.  


The study involved 21 neurosurgeons who had never worked with the RoboticScope before. After a standardized training session, participants conducted a single-level thoracolumbar decompression on human cadavers using the RoboticScope. A subsequent questionnaire on comfort and safety gauged their subjective experiences. Objective evaluations were conducted through the analysis of recorded interventions. (Demetz et al., 2024) 

Results & Conclusion

  • The study shows that after a structured training on the RoboticScope, there is a high level of confidence in using the RoboticScope for thoracolumbar decompression. 

  • The RoboticScope with a Head-Mounted Display offers surgeons a more ergonomic posture compared to conventional microscopes. 

  • 88% of participants felt confident using the RoboticScope in the operating room. 

  • 84% of participants expressed satisfaction with using the RoboticScope for thoracolumbar decompressions, with particular contentment regarding image quality and user-friendliness. 

  • The accuracy of the Head-Mounted Display setup was identified as a crucial factor influencing surgeons' comfort during procedures. 

  • Although half of the participants required technical support during the trial, the feedback from first-time users was extremely positive. 

In neurosurgery, the RoboticScope gives us the opportunity to combine the freedom of exoscopes with the unparallaled visualization of conventional surgical microscopes. In addition, the (head) gesture control makes it possible to carry out all operating procedures hands-free and without leaving the operating area.“

Christian F. Freyschlag, Vice Chairman, Department of Neurosurgery, University Clinic for Neurosurgery

Read the paper here. 


Demetz, M., Abramović, A., Krigers, A., Bauer, M., Lener, S., Pinggera, D., Kerschbaumer, J., Hartmann, S., Fritsch, H., Thomé, C., & Freyschlag, C. F. (2024). Cadaveric study of ergonomics and performance using a robotic exoscope with a head-mounted display in spine surgery. Journal of Robotic Surgery, 18(1).