How Neurosurgeons Are Using the Merge Cube to Revolutionize Anatomy Education

What if you could hold the human brain in your hand—and rotate it, explore it, and zoom in on intricate details—without ever stepping foot into an operating room? That’s exactly what a team of neurosurgeons from the Barrow Neurological Institute set out to do using an unexpected educational tool: the Merge Cube.

In a groundbreaking study published in the Journal of Neurosurgery (2024), researchers explored how photogrammetry and augmented reality (AR) technology can turn the Merge Cube into a portable neurosurgical lab, unlocking new ways for students and residents to engage with complex anatomy across the globe.

Interactive microsurgical anatomy education using photogrammetry 3D models and an augmented reality cube

OBJECTIVE This study sought to assess the use of an augmented reality (AR) tool for neurosurgical anatomical education. METHODS Three-dimensional models were created using advanced photogrammetry and registered onto a handheld AR foam cube imprinted with scannable quick response codes. A perspective analysis of the cube anatomical system was performed by loading a 3D photogrammetry model over a motorized turntable to analyze changes in the surgical window area according to the horizontal rotation. The use of the cube as an intraoperative reference guide for surgical trainees was tested during cadaveric dissection exercises. Neurosurgery trainees from international programs located in Ankara, Turkey; San Salvador, El Salvador; and Moshi, Tanzania, interacted with and assessed the 3D models and AR cube system and then completed a 17-item graded user experience survey. RESULTS Seven photogrammetry 3D models were created and imported to the cube. Horizontal turntable rotation of the cube translated to measurable and realistic perspective changes in the surgical window area. The combined 3D models and cube system were used to engage trainees during cadaveric dissections, with satisfactory user experience. Thirty-five individuals (20 from Turkey, 10 from El Salvador, and 5 from Tanzania) agreed that the cube system could enhance the learning experience for neurosurgical anatomy. CONCLUSIONS The AR cube combines tactile and visual sensations with high-resolution 3D models of cadaveric dissections. Inexpensive and lightweight, the cube can be effectively implemented to allow independent co-visualization of anatomical dissection and can potentially supplement neurosurgical education.

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The Challenge of Teaching Brain Surgery

Surgical anatomy is one of the most intricate and abstract subjects in medical education. Access to cadavers is limited, and not every neurosurgery program has the resources to support high-end dissection labs. So how do we bridge that gap and bring anatomy to life in a more accessible, hands-on way?

A Cube, a Smartphone, and Photogrammetry Magic

Using 3D reconstruction techniques called photogrammetry, researchers created lifelike anatomical models from cadaveric dissections. These detailed models were then embedded into the Merge Cube using scannable QR codes. With just a smartphone or tablet, trainees could explore 3D brain models from multiple angles simply by rotating the cube in their hands.

Whether it was identifying the optic carotid window or navigating the complex oculomotor corridor, users could manipulate the cube to shift surgical perspectives—just like adjusting the view through an operating microscope.

Tested Across the Globe

The AR cube system was tested in neurosurgery programs in Turkey, El Salvador, and Tanzania—locations where cadaver labs are rare or non-existent. In each setting, students and residents rated the tool highly for its educational value, ease of use, and ability to enhance their understanding of neuroanatomy.

• 94% agreed it was more engaging than traditional textbooks.
• 100% said it should be part of neurosurgical education.
• Zero reported motion sickness, visual fatigue, or discomfort.

Trainees didn’t just passively observe—they actively explored, zoomed, rotated, and learned from all angles. Instructors used the tool alongside live dissections, creating a dynamic hybrid learning experience.

Today’s Students Can Be the Creators, Too

What’s even more exciting is that students today don’t have to wait for a research fellowship or medical residency to start building with AR. With Merge Creator and the Merge Cube, students can scan real-world objects, label them with custom annotations, and present their 3D creations to the class or the world. Whether it’s a model of the heart, a handmade sculpture, or a digital replica of a community artifact, Merge empowers students to become active creators—not just consumers—of learning content. These student-built models can be used for presentations, science fairs, and even peer teaching, all while reinforcing spatial understanding and design thinking skills.

Why This Matters for Merge EDU

While this study focused on advanced neurosurgical education, the implications extend far beyond the operating room. It’s powerful validation of what we already know at Merge: hands-on AR learning works.

Just like young learners can explore cells, fossils, and the water cycle with Merge EDU apps, future surgeons can hold and explore anatomical models that were once confined to textbooks or inaccessible labs. This kind of multisensory learning—combining visual, tactile, and spatial understanding—isn’t just engaging, it’s transformative.

A Broader Shift in Medical Training

This research aligns with a broader trend we’re seeing across the medical field—augmented reality is becoming a critical tool in surgical planning, education, and practice. For example, Sira Medical is empowering surgeons with highly detailed, patient-specific 3D AR models to improve pre-surgical planning and reduce operating time. As we noted in our recent blog “Empowering Surgeons with Augmented Reality: Sira Medical’s Breakthrough”, AR isn’t just the future of learning—it’s the future of patient care, too.

Empowering Surgeons with Augmented Reality: Sira Medical’s Breakthrough

By incorporating the Merge Cube into their platform, Sira Medical not only enhances surgical training and patient education because of the hands-on nature of the Merge Cube, but also underscores the potential of AR technology in diverse professional settings.

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