{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T09:52:23Z","timestamp":1791366743262,"version":"4.3.1"},"reference-count":16,"publisher":"Georg Thieme Verlag KG","issue":"04","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg Rep"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Objective This study aimed to report the first in-human skull base neurosurgery case using Apple Vision Pro (AVP).<\/jats:p>\n                  <jats:p>Main Outcome Measures Endoscopic stream with the AVP in an endoscopic endonasal transsellar and left transcavernous approach for resection of a pituitary adenoma.<\/jats:p>\n                  <jats:p>Results Endoscopic endonasal approach was performed using the AVP for resection of a pituitary adenoma. The procedure was completed without complication. A postoperative magnetic resonance imaging (MRI) showed no convincing residual pituitary mass. The patient was discharged on postoperative day 2.<\/jats:p>\n                  <jats:p>Conclusion Endoscopic streaming to the AVP is safe in skull base surgery. We described the first case report of an AVP-specific spatial computing technology successfully used to display endoscopic feed to the skull base neurosurgeon during skull base neurosurgery with no intraoperative complications. Continued integration of intraoperative navigation platforms, patient vitals, preoperative imaging, and electronic medical records with endoscopic streams serves as an important step in optimizing surgeon experience and developing a virtual operating room.<\/jats:p>","DOI":"10.1055\/a-2945-8171","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T23:03:36Z","timestamp":1789686216000},"page":"e171-e176","source":"Crossref","is-referenced-by-count":0,"title":["Apple Vision Pro-Enabled Endoscopic Endonasal Approach for Pituitary Adenoma Resection: First In-Human Spatial Computing Skull Base Neurosurgery Case Report"],"prefix":"10.1055","volume":"87","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5846-9966","authenticated-orcid":false,"given":"Regan M.","family":"Shanahan","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine, Pennsylvania, United States","place":["Pittsburgh"]},{"name":"University of Pittsburgh Medical Center, Pennsylvania, United States","place":["Pittsburgh"],"department":["Department of Neurological Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ethan","family":"Crosby","sequence":"additional","affiliation":[{"name":"School of Computing and Information, University of Pittsburgh, Pennsylvania, United States","place":["Pittsburgh"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Griffin","family":"Hurt","sequence":"additional","affiliation":[{"name":"School of Computing and Information, University of Pittsburgh, Pennsylvania, United States","place":["Pittsburgh"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shovan","family":"Bhatia","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine, Pennsylvania, United States","place":["Pittsburgh"]},{"name":"University of Pittsburgh Medical Center, Pennsylvania, United States","place":["Pittsburgh"],"department":["Department of Neurological Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brock","family":"Gjesdal","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine, Pennsylvania, United States","place":["Pittsburgh"]},{"name":"University of Pittsburgh Medical Center, Pennsylvania, United States","place":["Pittsburgh"],"department":["Department of Neurological Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael R.","family":"Kann","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine, Pennsylvania, United States","place":["Pittsburgh"]},{"name":"University of Pittsburgh Medical Center, Pennsylvania, United States","place":["Pittsburgh"],"department":["Department of Neurological Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prajeet","family":"Santra","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine, Pennsylvania, United States","place":["Pittsburgh"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Calvin","family":"Brinkman","sequence":"additional","affiliation":[{"name":"School of Computing and Information, University of Pittsburgh, Pennsylvania, United States","place":["Pittsburgh"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rishi","family":"Basdeo","sequence":"additional","affiliation":[{"name":"School of Computing and Information, University of Pittsburgh, Pennsylvania, United States","place":["Pittsburgh"]},{"name":"Carnegie Mellon University, Pennsylvania, United States","place":["Pittsburgh"],"department":["Department of Mechanical Engineering"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3745-2727","authenticated-orcid":false,"given":"Garret W.","family":"Choby","sequence":"additional","affiliation":[{"name":"University of Pittsburgh Medical Center, Pennsylvania, United States","place":["Pittsburgh"],"department":["Department of Neurological Surgery"]},{"name":"University of Pittsburgh Medical Center, Pennsylvania, United States","place":["Pittsburgh"],"department":["Department of Otolaryngology\u2013Head and Neck Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios A.","family":"Zenonos","sequence":"additional","affiliation":[{"name":"University of Pittsburgh Medical Center, Pennsylvania, United States","place":["Pittsburgh"],"department":["Department of Neurological Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob T.","family":"Biehl","sequence":"additional","affiliation":[{"name":"School of Computing and Information, University of Pittsburgh, Pennsylvania, United States","place":["Pittsburgh"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward G.","family":"Andrews","sequence":"additional","affiliation":[{"name":"University of Pittsburgh Medical Center, Pennsylvania, United States","place":["Pittsburgh"],"department":["Department of Neurological Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"S103","DOI":"10.1227\/neu.0000000000003343","article-title":"Augmented reality in spine surgery","volume":"96","author":"B R Wilson","year":"2025","journal-title":"Neurosurgery"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1111\/os.14295","article-title":"Augmented reality navigation system enhances the accuracy of spinal surgery pedicle screw placement: a randomized, multicenter, parallel-controlled clinical trial","volume":"17","author":"Y Ma","year":"2025","journal-title":"Orthop Surg"},{"issue":"12","key":"ref3","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1097\/BRS.0000000000004338","article-title":"Augmented reality spine surgery navigation: increasing pedicle screw insertion accuracy for both open and minimally invasive spine surgeries","volume":"47","author":"B Felix","year":"2022","journal-title":"Spine"},{"key":"ref4","first-page":"111342","article-title":"Enhancing endoscopic spine surgery with intraoperative augmented reality: a case report","volume":"131","author":"D Y Park","year":"2025","journal-title":"Int J Surg Case Rep"},{"issue":"07","key":"ref5","doi-asserted-by":"crossref","first-page":"1318","DOI":"10.21037\/gs-2025-95","article-title":"The application of augmented reality technology in endoscopic pituitary adenoma surgery via nasal approach","volume":"14","author":"J Zhang","year":"2025","journal-title":"Gland Surg"},{"issue":"01","key":"ref6","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1007\/s11548-024-03225-9","article-title":"Augmented reality for endoscopic transsphenoidal surgery: evaluating design factors with neurosurgeons","volume":"20","author":"J Higa","year":"2025","journal-title":"Int J Comput Assist Radiol Surg"},{"issue":"04","key":"ref7","doi-asserted-by":"crossref","first-page":"151","DOI":"10.2176\/nmc.ra.2016-0276","article-title":"Recent evolution of endoscopic endonasal surgery for treatment of pituitary adenomas","volume":"57","author":"H Nishioka","year":"2017","journal-title":"Neurol Med Chir (Tokyo)"},{"issue":"04","key":"ref8","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1055\/s-0037-1607274","article-title":"Endoscopic endonasal reconstructive methods to the anterior skull base","volume":"31","author":"S Chakravarthi","year":"2017","journal-title":"Semin Plast Surg"},{"key":"ref9","first-page":"42","article-title":"Nasoseptal flap","volume":"74","author":"C D Pinheiro-Neto","year":"2013","journal-title":"Adv Otorhinolaryngol"},{"issue":"03","key":"ref10","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1207\/s15327108ijap0303_3","article-title":"Simulator sickness questionnaire: an enhanced method for quantifying simulator sickness","volume":"3","author":"R S Kennedy","year":"1993","journal-title":"Int J Aviat Psychol"},{"issue":"09","key":"ref11","doi-asserted-by":"crossref","first-page":"1961","DOI":"10.1007\/s00268-011-1141-4","article-title":"Development and validation of a surgical workload measure: the surgery task load index (SURG-TLX)","volume":"35","author":"M R Wilson","year":"2011","journal-title":"World J Surg"},{"issue":"11","key":"ref12","doi-asserted-by":"crossref","first-page":"4697","DOI":"10.1109\/TVCG.2023.3320214","article-title":"Understanding effects of visual feedback delay in AR on fine motor surgical tasks","volume":"29","author":"T Khan","year":"2023","journal-title":"IEEE Trans Vis Comput Graph"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"124562","DOI":"10.1016\/j.wneu.2025.124562","article-title":"Optimizing the workflow of superficial temporal artery mapping in extracranial-intracranial bypass surgery using mixed reality: a proof-of-concept study","volume":"204","author":"S Bhatia","year":"2025","journal-title":"World Neurosurg"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1227\/ons.0000000000002029","article-title":"Application of Mixed Reality in Endoscopic Streaming During Skull Base Surgery","author":"Y Choi","year":"2026","journal-title":"Oper Neurosurg"},{"issue":"07","key":"ref15","doi-asserted-by":"crossref","first-page":"2148","DOI":"10.3390\/cancers15072148","article-title":"Efficacy of a novel augmented reality navigation system using 3D computer graphic modeling in endoscopic transsphenoidal surgery for sellar and parasellar tumors","volume":"15","author":"Y Goto","year":"2023","journal-title":"Cancers"},{"issue":"03","key":"ref16","doi-asserted-by":"crossref","first-page":"e125","DOI":"10.5001\/omj.2020.43","article-title":"Challenges and practical considerations in applying virtual reality in medical education and treatment","volume":"35","author":"T Baniasadi","year":"2020","journal-title":"Oman Med J"}],"container-title":["Journal of Neurological Surgery Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2945-8171.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T09:10:33Z","timestamp":1791364233000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2945-8171"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,17]]},"references-count":16,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2026,10,6]]},"published-print":{"date-parts":[[2026,10]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2945-8171","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2193-6358","2193-6366"],"issn-type":[{"value":"2193-6358","type":"print"},{"value":"2193-6366","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,9,17]]},"published":{"date-parts":[[2026,9,17]]}}}