Minimally invasive and invasive liver surgery based on augmented reality training: a review of the literature

Abstract

A liver surgeon's knowledge of anatomy is critical. Due to the patient's small field of vision, patient specific, complex nerve system, and other factors, even a minor loss can result in irreversible damage. Surgeons could benefit from the use of augmented reality (AR) technology, which would bring three-dimensional image data into the operating room. AR visualization can improve surgical procedures, facilitate intraoperative planning, and enhance surgical guidance for the anatomy of interest, all of which contribute to the application's minimal invasiveness. This literature review on image guidance in liver surgery provides the reader with information about AR techniques. To ascertain the current state of Augmented reality technology's application in liver surgery, a PubMed and Embase search were conducted using the following keywords: < (Augmented reality) AND (liver surgery) > and < 'Augmented reality' AND 'liver surgery' > (publication date from January 1991 until Jun 2022). The query yielded a total of 205 publications-excluded papers in other languages, virtual reality (VR), and reviews leaving 135 studies for review. After removing duplication, the titles and abstracts of those studies were manually reviewed. Finally, 31 pertinent studies were determined to be pertinent to the subject. Generally, augmented reality technology includes preoperative planning and three-dimensional reconstruction, intraoperative three-dimensional navigation, and registration. Visualization may be aided by virtual three-dimensional reconstruction models of the liver from Computed Tomography/Magnetic Resonance Imaging scans. The results demonstrate that by utilizing augmented reality technology, blood vessels and tumor structures in the liver can be visualized during surgery, allowing for precise navigation during complicated surgical procedures. Augmented reality has been demonstrated to be safe and effective in both minimally invasive and invasive liver surgery. With recent advancements and significant effort by liver surgeons, augmented reality technologies have the potential to increase hepatobiliary surgical procedures dramatically. However, further clinical trials will be necessary to evaluate augmented reality as a tool for reducing post-operative morbidity and mortality. The impact of these cutting-edge computerized image guidance techniques on clinically relevant outcome parameters should be assessed in the future.

Keywords: Augmented reality; CT scan; Computer-assisted surgery system; Liver surgery; MR imaging.