{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T14:12:00Z","timestamp":1790604720578,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJUI Compass"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The aim of this study is to evaluate the effect of mixed reality (MR)\u2010assisted percutaneous nephrolithotomy (PCNL) on stone\u2010free rate (SFR), perioperative complications and operative efficiency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A search of PubMed, Embase and Web of Science from inception to February 2026 followed PRISMA guidelines. Studies comparing MR\u2010assisted versus standard fluoroscopic or ultrasound\u2010guided PCNL were included. Risk of bias was assessed using RoB2 and ROBINS\u2010I. Random\u2010effects meta\u2010analyses calculated standardized mean differences (SMD) or risk ratios (RR) with 95% confidence intervals (CI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Nine studies (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u2009774; 378 MR\u2010assisted, 396 control) met inclusion criteria; eight studies (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u2009730; 356 MR\u2010assisted, 374 control) were included in meta\u2010analysis. MR modalities included immersive virtual reality (VR) planning, holographic MR and CT\u2010ultrasound (US) fusion navigation. The MR\u2010assisted group had modest improvements in SFR compared to the control group (RR\u2009=\u20091.09; 95% CI 1.00\u20131.18;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u20090.044;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u200917.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u20090.29). Complication rates were similar between MR\u2010assisted and standard approaches. There was no statistically significant difference in puncture time between MR\u2010assisted and standard groups (SMD\u2009=\u2009\u22120.64; 95% CI \u22122.22 to 0.93;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u20090.42), with considerable heterogeneity. Similarly, there was no statistically significant difference in operative duration (SMD\u2009=\u2009\u22120.22; 95% CI \u20100.66 to +0.23;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u20090.34). While not meeting the threshold for pooled meta\u2010analysis, narratively, we found that MR\u2010assistance also reduced puncture attempts, blood loss and fluoroscopy time.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>MR\u2010assisted PCNL is associated with an apparent increase in SFR while maintaining comparable operative parameters and complication rates compared with standard techniques. Heterogeneity in these technologies and their applications limits generalizability. Larger, adequately powered standardized trials are recommended to interrogate key outcome measures including SFR and complication rates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bco2.70278","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T01:01:44Z","timestamp":1790038904000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mixed reality applications in percutaneous stone surgery: A systematic review and meta\u2010analysis of stone\u2010free rate and perioperative complications"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-2323-8789","authenticated-orcid":false,"given":"Christopher Yong\u2010Zyn","family":"Lo","sequence":"first","affiliation":[{"name":"Department of Urology Singapore General Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frida","family":"Toscano","sequence":"additional","affiliation":[{"name":"Anahuac North University  Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6862-6187","authenticated-orcid":false,"given":"John Joson","family":"Ng","sequence":"additional","affiliation":[{"name":"Duke\u2010NUS Medical School  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Du","family":"Jingzeng","sequence":"additional","affiliation":[{"name":"Department of Urology Singapore General Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3177-3439","authenticated-orcid":false,"given":"Archan","family":"Khandekhar","sequence":"additional","affiliation":[{"name":"Department of Urology University of Miami  Coral Gables Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4273-5502","authenticated-orcid":false,"given":"Hemendra","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Urology University of Miami  Coral Gables Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Marcovich","sequence":"additional","affiliation":[{"name":"Department of Urology University of Miami  Coral Gables Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4189-4572","authenticated-orcid":false,"given":"Julio","family":"Ojalvo","sequence":"additional","affiliation":[{"name":"Department of Computer Science University of Miami  Coral Gables Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarvesh","family":"Saini","sequence":"additional","affiliation":[{"name":"Department of Computer Science University of Miami  Coral Gables Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2175-0227","authenticated-orcid":false,"given":"Jonathan","family":"Katz","sequence":"additional","affiliation":[{"name":"Department of Urology University of Miami  Coral Gables Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"issue":"9","key":"e_1_2_11_2_1","first-page":"1021","article-title":"Application of video endoscope system (EVIS200) in endourology","volume":"38","author":"Washida H","year":"1992","journal-title":"Hinyokika Kiyo"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amsu.2021.102394"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.23736\/S2724-6051.22.04726-7"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.21037\/atm.2016.12.23"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.5152\/balkanmedj.2021.21957"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.23736\/S2724-6051.24.05888-9"},{"key":"e_1_2_11_8_1","unstructured":"EAU Guidelines.Edn. presented at the EAU Annual Congress London 2026."},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.69096"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1089\/end.2020.0888"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/iju.14907"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-016-0384-4"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-14-135"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/jrsm.1411"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000004284"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2022.12.067"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1089\/end.2018.0626"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2021.10.023"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-019-02801-y"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12894-024-01618-1"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2017.06.040"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/js9.0000000000002033"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10103-026-04843-2"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0126587"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2024.09.024"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.21037\/amj-20-174"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1177\/17562872231189924"}],"container-title":["BJUI Compass"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/bco2.70278","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/bco2.70278","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/bco2.70278","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T13:42:38Z","timestamp":1790602958000},"score":1,"resource":{"primary":{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/10.1002\/bco2.70278"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":26,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/bco2.70278"],"URL":"https:\/\/doi.org\/10.1002\/bco2.70278","archive":["Portico"],"relation":{},"ISSN":["2688-4526","2688-4526"],"issn-type":[{"value":"2688-4526","type":"print"},{"value":"2688-4526","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2026-04-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70278"}}