An image output system (100) includes a plurality of surgical instruments (120, 122, 124 210, 220, 230), where a positional and orientational relationship of each of the plurality of surgical instruments with respect to a target object (140) of a patients body (150) is determined. The image output system further includes at least one video image capture unit (132, 134 212, 222, 232) positioned on each of the plurality of surgical instruments and configured to selectively capture actual images (310 410, 420, 430). A virtual image generator (270) is presented for selectively defining, generating, and assigning virtual images (320 412, 422, 432) associated with the actual images relative to the target object (140) of the patients body (150), the virtual images derived from each of the plurality of surgical instruments. An image processor is also presented for processing the actual images captured and the virtual images generated. Additionally, an image output device (102, 104 290 340) for displaying combinations (330 440) of the actual images captured and the virtual images generated in a plurality of configurations is presented.
