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Augmented intelligence in "robotic" liver surgery: Integrating augmented reality and artificial intelligence for
12 Department of Surgery, Aretaieio University Hospital, National and Kapodistrian University of Athens, Athens 11528, Greece. sofrozan@gmail.com.
Abstract:
"Robotic" liver surgery has revolutionized minimally invasive hepatectomy, offering superior dexterity and visualization, but achieving accurate intraoperative navigation and safe resection margins remains difficult, especially for deep or posterior hepatocellular carcinomas. The convergence of augmented reality (AR) and artificial intelligence (AI), collectively described as augmented intelligence, is emerging as a transformative approach. We review the current evidence and future prospects of AR- and AI-assisted "robotic" liver surgery, focusing on their role in real-time anatomical guidance and margin control. Recent developments allow for real-time overlay of 3D reconstructions of the liver and segmentation of tumors and vascular structures, facilitating dynamic visualization and intraoperative decision-making. However, surgical and anatomical challenges, for instance, organ deformation, registration errors, and the lack of standardized protocols, limit its widespread adoption. Augmented intelligence represents the next frontier in "robotic" liver surgery, offering a path toward safer, more personalized, and data-driven hepatectomies.

