# Technology Behavior Model--Beyond Your Sight with Extended Reality in Surgery
## 1 Introduction  
During clinical surgery, surgeons need to monitor and view multiple visualization instruments, including endoscopes, laparoscopes, cardiac monitors, and others [1]. The surgeons always observe the display data and images by means of rotating their head, as far as to result in torso distortion due to of maintaining a fixed position for long periods of time [2]. Data and images are transmitted to the glasses through WIFI when using smart glasses for surgery [3]. Their eye does not move and focus on the surgical operation. In some delicate surgeries the clarity of human eyes cannot meet the demand, and surgeons need to use a microscope to perform the surgery [4], for instance, vestibular schwannoma of the brain [5], dental pulp nerve endings [6], and intracranial dual arteriovenous fistulae [7]. Nevertheless, the microscope is too bulky and has a small operable interface which is not conducive to surgical operations. Smart Glasses have high-definition cameras with adjustable focal lengths to improve the clarity of the human eye [8]. Meanwhile, the surgeon's hands are freed and facilitate flexible manual operation. Extended reality is a deep immersion experience that generates a comprehensive, three-dimensional reality-virtual continuum through computer systems. Through Virtual Reality (VR) to provide users with a virtual environment, combined with digital overlay enhanced images in Augmented Reality (AR), and use of Mixed Reality (MR) to form three-dimensional imaging, to achieve a perfect combination of physical reality environmentand virtual reality environment, as shown in Figure 1[9]. It promotes regional innovation and opens up new visualization avenues of application. The human body is complex and mobile, moving the internal organs of the body between exhalation and inhalation [10]. Each part is a relatively independent and complex structure. During the operation, it can overlap with the patient entity, which is convenient for the surgeon to recognize and operate [11; 12]. XRSG uses Expanded Reality Technology (XRT) that can create images of such sensitive images. Most important is the visual experience, which combines real and virtual human structures to create a three-dimensional, realistic medical image of the human body [13]. Past works of literature on XRT in surgery have been insufficiently discussed. However, from the point of view of theoretical development, the XRSG technique has met the needs of surgical procedures, such as trials in dermatology [14], neurosurgery [9], and urological procedures [15], but has not yet been applied to clinical procedures [16]. In this study, the acceptability and feasibility of the use of XRSG for surgical operations by medical specialists were tested. The XRT was studied using the Technology Acceptance Model (TAM) to explore people's acceptance of innovation through their perception of its usefulness and ease of use [17]. It also requires the acceptance and use of subjective consciousness leading to behavioral change suitable for the Theory of Planned Behavior (TPB) through the medical expert's experience of the procedure [18]. The current study proposes a new theoretical framework with a combination of TAM and TPB, the Technology Behavior Model (TBM). In this model, extended reality technology is added to make it more suitable for this study. Currently, XRSG is mainly used to improve visual effects and is not as popular as cell phones. Therefore, people's subjective perceptions are the basis of their behaviors. In this study, the triangle mixed research method was used to collect data through an online Google questionnaire and conduct statistical analysis on the data using SmartPLS. PLS-SEM has a multiplanar structure and sophisticated model manipulation software that allows for multivariate mixed cross-tabulation analysis, which facilitates the study of the data [19]. The structure of this paper is as follows. First, the theory and hypotheses of this study are presented by examining the previous literature.