Abstract

Disparities in surgical outcomes often result from subjective decisions dictated by surgical training, experience, and available resources. To improve outcomes, surgeons have adopted advancements in robotics, endoscopy, and intra-operative imaging including fluorescence-guided surgery (FGS), which helps visualize tumor margins. However, existing FGS systems are bulky, expensive, and not suited for widespread use. Here, we present a frugal engineering-inspired, wearable, augmented reality (AR) goggle system that enables FGS in real-time. This head-mounted display integrates a small, low-cost near-infrared camera with a smartphone-based projection system for overlaid fluorescence. We validated its performance in phantoms and a preclinical cancer model, showing comparable tumor visualization and resection performance to conventional systems. Our results support the potential for low-cost, wearable FGS platforms to improve access to advanced surgical imaging, particularly in resource-limited settings.