Preoperative visualisation tools for surgical effects in shared decision-making: A scoping review.

Abstract

Preoperative visualisation tools may support patient education and shared decision-making by helping patients understand anticipated postoperative outcomes. This scoping review asked: in preoperative doctor-patient shared decision-making for elective surgery, what patient-facing visualisation tools have been reported to depict anticipated changes in patient's anatomy; in which surgical contexts have they been used; how have they been incorporated into decision-making; and what outcomes have been evaluated? A scoping review was conducted following JBI methodology and PRISMA-ScR guidelines. PubMed, EMBASE, Scopus, CINAHL, Web of Science, and Cochrane Library were searched for studies published from 1 January 2020-27 March 2025, using search terms derived from the research question, to identify studies that used visualisation tools during preoperative doctor-patient shared decision-making to depict postoperative changes in appearance, anatomy, or physical function. Extracted data included study characteristics, tool features, surgical context, shared decision-making application, and objective or patient-reported outcome measures related to use of the visualisation tool. A descriptive numerical summary and narrative synthesis were performed. The search identified 22,384 records, of which eight studies met the inclusion criteria. Seven studies concerned breast-related procedures, including breast augmentation (n = 5) and breast-conserving surgery (n = 2); one study concerned high tibial osteotomy. Five different visualisation systems were described, most commonly the Vectra 3D platform (n = 4). Across studies, patients reported better understanding of anticipated outcomes, improved communication with clinicians, and, in some cases, greater decisional confidence. Formal assessments of simulation accuracy were uncommon and limited to breast augmentation, where reported accuracy was generally high. Published evidence on patient-facing visualisation tools for surgical shared decision-making remains limited and concentrated in breast surgery. Future efforts should develop accessible, validated visualisation tools across broader surgical fields and evaluate their effects on comprehension, expectation-setting, communication, decisional confidence, and technical accuracy.