ArticleBMJ connections surgery2026
Preliminary clinical experience using the Leica ARveo with MyVeo in neurosurgery: an IDEAL stages 1 and 2a observational study.
Article in BMJ connections surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To report the initial clinical experience with the Leica ARveo system with MyVeo in neurosurgery, focusing on feasibility, ergonomics and visualisation characteristics during early clinical implementation. Design: This observational study was conducted in accordance with the IDEAL framework (stages 1 and 2a: Idea/Development and Exploration). Setting: Department of Neurological Surgery, Nippon Medical School Hospital, Tokyo, Japan. Participants: Six patients undergoing neurosurgical procedures, including three aneurysm clippings, two microvascular decompressions and one superficial temporal artery-to-middle cerebral artery bypass for moyamoya disease. Intervention: MyVeo was used either by the assistant (cases 1-3) or collaboratively by the primary surgeon and assistant (cases 4-6), reflecting staged clinical implementation. Main outcome measures: Feasibility, ergonomics, visualisation characteristics, operative workflow and intraoperative safety were assessed based on intraoperative observations and team feedback. Results: All procedures were completed without intraoperative complications. MyVeo allowed flexible viewing and facilitated shared visualisation among surgical team members, with reported improvements in ergonomics and intraoperative collaboration. However, limitations were identified, including lower image resolution and depth perception compared with conventional microscopes as well as neck fatigue and workflow challenges related to cable management. The system required adaptation during use, particularly in the early phase. Conclusions: The use of Leica ARveo with MyVeo was feasible in this small case series and provided ergonomic and collaborative advantages in selected scenarios. However, given its current limitations in visualisation performance and system integration, it should be considered a complementary tool rather than a replacement for conventional operating microscopes. Further studies with objective outcome measures are required to define its clinical role.
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