The application and prospection of augmented reality in hepato-pancreato-biliary surgery

Augmented Reality (AR) is one of the main forms of Extended Reality (XR) application in surgery. hepato-pancreato-biliary (HPB) surgeons could benefit from AR as an efficient tool for making surgical plans, providing intraoperative navigation, and enhancing surgical skills. The introduction of AR to HPB surgery is less than 30 years but brings profound influence. From the early days of projecting liver models on patients' surfaces for locating a better puncture point to today's assisting surgeons to perform live donor liver transplantation, a series of successful clinical practices have proved that AR can play a constructive role in HPB surgery and has great potential. Thus far, AR has been shown to increase efficiency and safety in surgical resection, and, at the same time, can improve oncological outcomes and reduce surgical risk. Although AR has presented admitted advantages in surgery, AR's application is still immature as an emerging technique and needs more exploration. In this paper, we reviewed the principles of AR and its developing history in HPB surgery, describing its significant practical applications over the past 30 years. Reviewing the past attempts of AR in HPB surgery could make HPB surgeons a better understanding of future surgery and the digital trends in medicine. The routine uses of AR in HPB surgery, as an indication of the operating room entering the new era, is coming soon.