Applicability of augmented reality in perioperative liver resection

Liver resection ranks among the most technically demanding abdominal procedures, requiring detailed knowledge of complex three-dimensional anatomy. Augmented reality (AR) represents an innovative technology that overlays digital information on the surgical field and may serve as a tool for perioperative navigation.

A systematic search of PubMed, MEDLINE, and Cochrane databases was conducted for studies published between January 2022 and August 2025. Only articles in En-glish focusing on human subjects and describing the use of AR during liver resection were included. A total of 133 studies were identified; after removing duplicates, 67 remained. Based on predefined criteria, 10 studies were finally considered relevant for analysis.

The analyzed studies involved 649 patients, of whom 245 underwent liver resection with AR assistance. Five were retrospective with control groups, three were single-arm, and one was prospective. Most studies demonstrated that AR improved intraoperative orientation, facilitated lesion localization, and could reduce blood loss and operative time. In cases of deep-seated lesions, AR was associated with wider resection margins, higher R0 resection rates, and fewer conversions. Conversely, long-term oncologic outcomes and postoperative complication rates were not consistently affected.

AR appears to be a safe technique with the potential to enhance the precision of liver resections and support intraoperative decision-making. Nevertheless, large prospective trials and further technological advances in registration and tissue deformation correction are required before routine clinical implementation.