A Conceptual Framework for 4D Holographic Visualization in Gastrointestinal Endoscopy: Toward Externalized Spatiotemporal Cognition.

This viewpoint explores the concept of 4D holographic visualization in gastrointestinal endoscopy and discusses its potential implications from a medical informatics perspective. Current endoscopic practice relies primarily on 2D image displays, requiring operators to mentally reconstruct 3D spatial relationships and temporal changes in a dynamic and deformable anatomical environment. The aim of this viewpoint is to present a conceptual framework that reframes endoscopic visualization as a spatiotemporal information integration problem rather than solely a display problem. We discuss how future visualization systems may integrate spatial and temporal information to support externalized representations of anatomy, endoscope configuration, and procedural dynamics in a shared clinical environment. Potential applications include endoscopic navigation, training, and collaborative procedures. We further discuss key technical and clinical considerations, including information integration, registration stability, real-time responsiveness, workflow compatibility, and uncertainty associated with reconstructed information. This viewpoint highlights spatiotemporal information integration as a central challenge in the development of next-generation visualization systems for gastrointestinal endoscopy.