Anatomy on the Border Expert Consensus Meeting: Current Status and Future Perspectives of Three-Dimensional Image...

The Japan Society for Endoscopic Surgery organized the Anatomy on the Border Expert Consensus Meeting in 2024 to foster cross-disciplinary discussions. One of the themes, on parenchymal organs, brought together liver, lung, and kidney specialists to jointly discuss the current status and future perspectives of three-dimensional image reconstruction and augmented/virtual/mixed reality technologies in surgery. This report summarizes the results of these discussions in relation to liver surgery.

A questionnaire was distributed to board-certified expert training facilities of the Japanese Society of Hepato-Biliary-Pancreatic Surgery and liver surgeons certified by the Japan Society for Endoscopic Surgery. A systematic review of English language articles published between 2015 and 2024 was also conducted.

Responses were obtained from 86 institutions. The majority (88%) reported routine use of three-dimensional image reconstruction, mainly for preoperative planning (92%) and anatomical understanding (88%). It was rated as very or moderately useful by 99% of respondents. A literature review confirmed the perioperative benefits of this technique. In contrast, augmented/virtual/mixed reality technologies were used in only 16% of the institutions; the majority of these (79%) acknowledged their usefulness, primarily for anatomical understanding and education. The barriers to implementation included cost and data preparation complexity. The educational benefits were supported by data from randomized controlled trials; however, clinical evidence remains limited and inconsistent.

Three-dimensional image reconstruction has become essential in liver surgery. Augmented/virtual/mixed reality technologies, although in the early stages, show promise for surgical education and may eventually contribute to surgical practice as accessibility improves.