{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T16:28:35Z","timestamp":1784305715794,"version":"3.55.0"},"reference-count":25,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:00:00Z","timestamp":1763596800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"a Pilot Award from the UC Irvine Institute for Clinical and Translational Science"},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Projected augmented reality (PAR) enables real-time projection of digital surgical information directly onto the operative field. This offers a hands-free, headset-free platform that is universally visible to all members of the surgical team. Compared to head-mounted display systems, which are limited by restricted fields of view, ergonomic challenges, and user exclusivity, PAR provides a more intuitive and collaborative surgical interface. When paired with artificial intelligence (AI), PAR has the potential to automate aspects of surgical planning and deliver high-precision guidance in both high-resource and global health settings. Our team is working on the development and validation of a PAR platform to dynamically project surgical and anatomic markings directly onto the patients intraoperatively. Methods: We developed a PAR system using a structured light scanner and depth camera to generate digital 3D surface reconstructions of a patient\u2019s anatomy. Surgical markings were then made digitally, and a projector was used to precisely project these points directly onto the patient\u2019s skin. We also developed a trained machine learning model that detects cleft lip landmarks and automatically designs surgical markings, with the plan to integrate this into our PAR system. Results: The PAR system accurately projected surgeon and AI-generated surgical markings onto anatomical models with sub-millimeter precision. Projections remained aligned during movement and were clearly visible to the entire surgical team without requiring wearable hardware. Conclusions: PAR integrated with AI provides accurate, real-time, and shared intraoperative guidance. This platform improves surgical precision and has broad potential for remote mentorship and global surgical training.<\/jats:p>","DOI":"10.3390\/jcm14228246","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T13:25:27Z","timestamp":1763645127000},"page":"8246","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Projected Augmented Reality in Surgery: History, Validation, and Future Applications"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5383-9809","authenticated-orcid":false,"given":"Nikhil Dipak","family":"Shah","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, University of California, Irvine, CA 92697, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lohrasb","family":"Sayadi","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, University of California, Irvine, CA 92697, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peyman","family":"Kassani","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, University of California, Irvine, CA 92697, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raj","family":"Vyas","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, University of California, Irvine, CA 92697, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1093\/asj\/sjz043","article-title":"New Frontier: A Review of Augmented Reality and Virtual Reality in Plastic Surgery","volume":"39","author":"Sayadi","year":"2019","journal-title":"Aesthet. 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