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Technological Advances in Intra-Operative Navigation: Integrating Fluorescence, Extended Reality, and Artificial
Edward Murphy1, Ronan A Cahill1,2
1UCD Centre for Precision Surgery, 47 Eccles Street, Phibsboro, D07 Y9AW Dublin, Ireland.
Journal of Clinical Medicine
|December 11, 2025
Summary
Surgical navigation is advancing with fluorescence-guided surgery (FGS), extended reality (XR), and artificial intelligence (AI) for better visualization and decision support. Integrating these technologies promises enhanced precision and safety in surgery, despite current challenges.
Area of Science:
- Medical technology
- Surgical innovation
- Image-guided surgery
Background:
- Surgical navigation has evolved from landmark-based methods to complex soft-tissue surgery applications.
- Fluorescence-guided surgery (FGS), often using indocyanine green (ICG), is increasingly used for perfusion assessment, lymphatic mapping, and biliary anatomy.
- Extended reality (XR) and artificial intelligence (AI) are emerging as key technologies in surgical navigation.
Purpose of the Study:
- To explore the convergence of fluorescence-guided surgery (FGS), extended reality (XR), and artificial intelligence (AI) in surgical navigation.
- To highlight the potential of these technologies in enhancing real-time visualization and decision support.
- To identify barriers to the broad clinical deployment of advanced surgical navigation systems.
Main Methods:
- Review of current applications of fluorescence-guided surgery (FGS) using indocyanine green (ICG).
- Discussion of the role of extended reality (XR) in overlaying 3D reconstructions for spatial orientation.
- Exploration of artificial intelligence (AI) for data analysis and surgical decision support.
Main Results:
- FGS demonstrates improved surgical safety and efficacy in various applications.
- XR platforms enhance spatial orientation by overlaying 3D models onto the surgical field.
- AI has the potential to standardize interpretation and guide surgical decisions through complex data analysis.
Conclusions:
- The integration of FGS, XR, and AI is the future of surgical navigation, promising enhanced precision, safety, and outcomes.
- Further development is needed to overcome technical, evidence-based, training, regulatory, and ethical challenges.
- This integrated approach will remain adaptable to future innovations in surgical imaging and therapy.
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