Laparoscopic Liver Resection with Augmented Reality: A Preclinical Experience.

Area of Science:

• Surgical Technology
• Medical Imaging
• Augmented Reality

Background:

• Standard laparoscopy lacks subsurface anatomical detail.
• Integrating intraoperative imaging like ultrasound with laparoscopy is challenging.
• A novel augmented reality (AR) system aims to fuse laparoscopic ultrasound (LUS) and laparoscopic video in real time.

Purpose of the Study:

• To evaluate the initial application of a novel AR laparoscopic system.
• To demonstrate real-time integration of LUS images with laparoscopic video.
• To assess the system's utility in laparoscopic hepatic wedge resection in a porcine model.

Main Methods:

• An AR system was developed using standard laparoscopy, LUS, an electromagnetic tracking system, and a laptop for image fusion.
• Two liver lesions created by radiofrequency ablation (RFA) in a porcine model were resected.
• The novel AR system and standard laparoscopy were used for comparison.

Main Results:

• LUS anatomical details were successfully fused with laparoscopic video in real time.
• The AR system facilitated the resection of a 2.5 cm lesion in approximately 7 minutes.
• Both lesions were resected with clear margins, indicating successful removal.

Conclusions:

• The AR system successfully integrated LUS and standard laparoscopy for hepatic wedge resection in a porcine model.
• The system demonstrated potential for real-time image fusion and improved visualization.
• Further testing and experience may lead to broader applications in other laparoscopic procedures.