Clinical use of augmented reality, mixed reality, three-dimensional-navigation and artificial intelligence in liver surgery

Table 3 Augmented and mixed reality for 3D Navigation

Ref.	Number of procedures	Technique	Key outcomes
Beller et al[29], 2007	33 open liver resections	Stereotactic optical navigation system, combined with a virtual 3D model and ultrasound, dissection device tracked and navigated on ultrasound image	Navigation successful in 32/33 cases, difference between projected and actual vascular dissection lever 6mm, R0 resection in 30 cases
Peterhans et al[10], 2011	9 open liver resections	Stereotactic navigation system, combined with a virtual 3D model and ultrasound, landmark acquisition on the liver surface, dissection device tracked and navigated on the virtual 3D model	Navigation successful in all cases, median accuracy 6.3 mm
Banz et al[32], 2016	65 open liver resections	Stereotactic optical navigation system, combined with a virtual 3D model and ultrasound, dissection device tracked and navigated on the virtual 3D model, landmark acquisition with ultrasound possible	Combination of 3 d navigated resection and thermal ablation in 16 patients, accuracy optimized to 4.5 ± 3.6 mm
Tinguely et al[35], 2017	54 laparoscopic image guided microwave ablation	Laparoscopic stereotactic navigation system, combined with a virtual 3D model, landmark acquisition on the liver surface, ablation device tracked and navigated on the virtual 3D model, standard 2D laparoscopic display	Registration time 4:38 min, accuracy 8.1 ± 2.8 mm, early local recurrence rate 32%
Aoki et al[37], 2021	27 laparoscopic liver lesions	virtual real-time CT-guided volume navigation, electromagnetic tracking of the surgical instruments displayedon the preoperatively acquired CT images	Registration time < 2 min, registration error 12 mm, histologic resection margin 9 mm
Prevost et al[26], 2020	10 laparoscopic liver resections	stereotactic augmented reality navigation, virtual 3D liver model superimposed on the real liver with a 3D laparoscopic system, instruments tracked	Registration time 8:50 min, registration error 9.2 mm, facilitates to find disappeared liver lesions

AR: Augmented reality; 3D: Three-dimensional.