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Updated: Oct 24, 2026
Laparoscopic Anatomical Hepatectomy Using Takasaki's Approach and Indocyanine Green Fluorescence Navigation
Published on: May 16, 2025
Anatomical landmark-based proportional coordinate localization in laparoscopic partial nephrectomy for completely
Yapeng Sui1, Xiang Zhang1, Ziwei Wei2
1Department of Urology, Qilu Hospital, Shandong University, Jinan, 250014, People's Republic of China.
Background:
Accurate localization of completely endophytic renal tumors remains challenging in laparoscopic partial nephrectomy, and conventional intraoperative ultrasonography is experience-dependent.
Objective:
To evaluate an intraoperative localization technique based on AI-assisted three-dimensional reconstruction and an anatomical landmark-based proportional coordinate system (XYZ).
Methods:
We retrospectively analyzed 105 patients treated from May 2016 to July 2025. Patients were assigned to the XYZ coordinate-guided localization group (n = 52), using preoperative three-dimensional planning, calculation of the proportional XYZ coordinates, and intraoperative ultrasonographic verification, or the traditional localization group (n = 53), using conventional imaging and intraoperative ultrasonographic scanning. Localization efficiency, perioperative outcomes, and trifecta achievement were compared.
Results:
Baseline characteristics were comparable. Compared with the traditional localization group, the XYZ coordinate-guided localization group had shorter localization time (225.5 s vs 317.0 s, p < 0.001), higher first-attempt localization success rate (59.62% vs 37.74%, p = 0.025), shorter warm ischemia time (21.73 min vs 27.19 min, p < 0.001), and higher trifecta achievement rate (61.54% vs 24.52%, p < 0.001). Estimated blood loss was lower (105.0 mL vs 130.0 mL, p = 0.035), blood transfusion tended to be reduced (3.85% vs 16.98%, p = 0.052), and acute kidney injury was less frequent (11.54% vs 28.30%, p = 0.032). Multivariable regression confirmed XYZ coordinate-guided localization group was associated with higher odds of achieving the trifecta and shorter warm ischemia time.
Conclusion:
In the present study, XYZ coordinate-guided localization was associated with shorter intraoperative localization and warm ischemia times and a higher rate of achieving the trifecta than traditional localization. We will conduct prospective multicenter studies to further evaluate its effectiveness and generalizability.
