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Augmented Reality Navigation Plus Indocyanine Green Fluorescence Imaging Can Accurately Guide Laparoscopic Anatomical Segment 8 Resection

Annals of Surgical Oncology volume 30, pages 7373–7383 (2023)Cite this article

Abstract

Background

Laparoscopic anatomical Segment 8 (S8) resection is a highly challenging hepatectomy. Augmented reality navigation (ARN), which could be combined with indocyanine green (ICG) fluorescence imaging, has been applied in various complex liver resections and may also be applied in laparoscopic anatomical S8 resection. However, no study has explored how to apply ARN plus ICG fluorescence imaging (ARN–FI) in laparoscopic anatomical S8 resection, or explored its accuracy.

Patients and Methods

This study is a post hoc analysis that included 31 patients undergoing laparoscopic anatomical S8 resection from the clinical NaLLRFI trial, and the resected liver volume was measured in each patient. The perioperative parameters of safety and feasibility, as well as the accuracy analysis outcomes were compared.

Results

There were 16 patients in the ARN–FI group and 15 patients underwent conventional laparoscopic hepatectomy without ARN or fluorescence imaging (non-ARN–FI group). There was no significant difference in baseline characteristics between the two groups. Compared with the non-ARN–FI group, the ARN–FI group had lower intraoperative bleeding (median 125 vs. 300 mL, P = 0.003). No significant difference was observed in other postoperative short-term outcomes. Accuracy analysis indicated that the actual resected liver volume (ARLV) in the ARN–FI group was more accurate.

Conclusions

ARN–FI was associated with less intraoperative bleeding and more accurate resection volume. These techniques may address existing challenges and provide rational guidance for laparoscopic anatomical S8 resection.

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Acknowledgment

This study was supported by the National Natural Science Foundation of China (Grant No. 82272132); China Postdoctoral Science Foundation (Grant No. 2022M721514); President's Fund of Zhujiang Hospital (Grant No. yzjj2022qn31); Basic and Applied Basic Research Foundation of Guangdong Province (Grant No. 2021A1515011869); the Science and Technology Plan Project of Guangdong Province (Grant No. 2021A1414020003); Regional Joint Fund of Guangdong (Guangdong-Hong Kong-Macao Research Team Project) (Grant No. 2021B1515130003).

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Author notes

  1. Haisu Tao, Zhuangxiong Wang, and Xiaojun Zeng have contributed equally to this work as co-first authors.

Authors and Affiliations

  1. Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, China

    Haisu Tao MD, Zhuangxiong Wang MM, Xiaojun Zeng MM, Haoyu Hu MD, Jinyu Lin MD, Wenjun Lin MM, Chihua Fang MD & Jian Yang MD

  2. Guangdong Provincial Clinical and Engineering Center of Digital Medicine, Guangzhou, China

    Haisu Tao MD, Zhuangxiong Wang MM, Xiaojun Zeng MM, Haoyu Hu MD, Jinyu Lin MD, Wenjun Lin MM, Chihua Fang MD & Jian Yang MD

  3. The First Affiliated Hospital, College of Medicine, Shihezi University, Shihezi, China

    Jiang Li MD

  4. Pazhou Lab, Guangzhou, China

    Chihua Fang MD & Jian Yang MD

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  1. Haisu Tao MD
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Correspondence to Chihua Fang MD or Jian Yang MD.

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Tao, H., Wang, Z., Zeng, X. et al. Augmented Reality Navigation Plus Indocyanine Green Fluorescence Imaging Can Accurately Guide Laparoscopic Anatomical Segment 8 Resection. Ann Surg Oncol 30, 7373–7383 (2023). https://doi.org/10.1245/s10434-023-14126-7

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