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Augmented Reality-Assisted Laparoscopic Adrenalectomy

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Augmented reality (AR) is the superimposition of virtual-reality reconstructions onto a real patient’s images, in real time. This results in the visualization of internal structures through overlying tissues, providing a virtual transparency vision of surgical anatomy. We report what we believe is the first use of AR technology for general surgery in humans.

Augmented reality aided the laparoscopic adrenalectomy by helping determine the correct dissection planes and by localizing the tumor, adjacent organs, and blood vessels. Augmented reality was most useful during identification of the main adrenal vein, the location of which was accurately predicted by the AR imaging, leading to its safe isolation through a virtual transparency of the fatty tissue in which it was embedded.

Potential advantages of the use of AR in general surgery include the delineation of dissection planes or resection margins and the avoidance of injury to invisible structures. Augmented reality has the potential to facilitate performance of radical surgical therapy by minimizing dissection and resection of neighboring tissues and organs and may be useful as a tool for a more interactive form of expert distant telementoring. Furthermore, by enabling visualization of intra-abdominal structures through virtual transparency of the abdominal wall, AR might improve safety and efficacy of various percutaneous techniques such as radiofrequency liver tumor ablation. The use of AR in general surgery will be simplified if automated image registration is developed.


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