增强现实导航联合荧光腹腔镜技术在肝中叶肿瘤切除术中的应用OA

Background and Aims:Laparoscopic resection of centrally located hepatic tumors remains technically demanding due to the complex anatomical relationships with major vascular structures.Conventional intraoperative ultrasound or indocyanine green fluorescence imaging(ICG-FI)alone has limitations,particularly in visualizing deep anatomical structures.This study aimed to evaluate the clinical value of augmented reality(AR)navigation combined with ICG-FI in laparoscopic resection of central hepatic tumors. Methods:A retrospective analysis was conducted on 38 consecutive patients who underwent laparoscopic resection of central hepatic tumors guided by AR navigation combined with ICG-FI between May 2022 and March 2025.Intraoperative navigation performance,surgical parameters,and perioperative outcomes were assessed. Results:All 38 procedures were completed laparoscopically without conversion.The intraoperative tumor fluorescence detection rate was 100%.The mean operative time was(324.9±132.4)min,and the median intraoperative blood loss was 400(50-1 200)mL.The mean registration error was(6.3±0.6)mm.The median number of predicted and verified vessels was 6(4-8)and 7(5-10),respectively.R0 resection was achieved in all patients,with a mean surgical margin of(1.5±0.5)cm.The postoperative complication rate was 13.2%,with no severe complications such as intra-abdominal hemorrhage,gas embolism,or liver failure.The median postoperative hospital stay was 9(4-20)days.During a median follow-up of 20 months,no tumor recurrence was observed. Conclusion:The combined use of AR navigation and ICG-FI enables intraoperative prediction and verification of critical vascular structures and facilitates precise control of the transection plane in laparoscopic resection of central hepatic tumors.This technique improves surgical precision and safety and shows promising clinical potential.