Wisotzky, EricEricWisotzkyRosenthal, Jean-ClaudeJean-ClaudeRosenthalMeij, SennaSennaMeijDobblesteen, John van denJohn van denDobblesteenArens, PhilippPhilippArensHilsmann, AnnaAnnaHilsmannEisert, PeterPeterEisertUecker, Florian CorneliusFlorian CorneliusUeckerSchneider, ArminArminSchneider2023-05-122023-05-122023https://publica.fraunhofer.de/handle/publica/44191710.1177/1357633X2311662262-s2.0-85146931558Existing challenges in surgical education (See one, do one, teach one) as well as the COVID-19 pandemic make it necessary to develop new ways for surgical training. Therefore, this work describes the implementation of a scalable remote solution called "TeleSTAR" using immersive, interactive and augmented reality elements which enhances surgical training in the operating room. The system uses a full digital surgical microscope in the context of Ear-Nose-Throat surgery. The microscope is equipped with a modular software augmented reality interface consisting an interactive annotation mode to mark anatomical landmarks using a touch device, an experimental intraoperative image-based stereo-spectral algorithm unit to measure anatomical details and highlight tissue characteristics. The new educational tool was evaluated and tested during the broadcast of three live XR-based three-dimensional cochlear implant surgeries. The system was able to scale to five different remote locations in parallel with low latency and offering a separate two-dimensional YouTube stream with a higher latency. In total more than 150 persons were trained including healthcare professionals, biomedical engineers and medical students.enannotationsear-nose-throatlive streamingmixed realitypandemicsurgical trainingtelehealthTelepresencejournal article