中国普通外科杂志2026，Vol.35Issue(1)：88-96,9.DOI:10.7659/j.issn.1005-6947.250468
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
Application of augmented reality navigation combined with indocyanine green fluorescence imaging in laparoscopic resection of central hepatic tumors
摘要
Abstract
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.关键词
肝切除术/腹腔镜/增强现实/手术导航系统/吲哚花青绿Key words
Hepatectomy/Laparoscopes/Augmented Reality/Surgical Navigation Systems/Indocyanine Green分类
医药卫生引用本文复制引用
沈正超,陈志远,奚士航,潘璇,钱道海,MUHAMMAD Danish Irshad,王小明..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[J].中国普通外科杂志,2026,35(1):88-96,9.基金项目
安徽省卫生健康中青年科研基金资助项目(AHWJ2024Aa30111) （AHWJ2024Aa30111）
安徽省临床医学研究转化专项基金资助项目(202427b10020049) （202427b10020049）
安徽省高校自然科学研究重大基金资助项目(2023AH040254). （2023AH040254）
