Application Of Mixed Reality Technology And Surgical Navigation In Liver Surgery Based On 3D Reconstruction

Objective: To explore the application of mixed reality technology based on 3D reconstruction and intraoperative navigation in the perioperative period of liver surgery.Methods: The clinical data of 60 patients undergoing laparoscopic liver resection for liver occupation lesions from March 2018 to March 2022 were analyzed retro.60 cases were divided into mixed reality groups(mixed reality,MR)and non-mixed reality(NMR)according to whether mixed reality technology was used.We compared preoperative data,perioperative outcomes,and recurrence in both groups and presented our initial experience using mixed reality technique navigation surgery in laparoscopic liver surgery.Results: All patients completed laparoscopic liver resection with negative microscopic margins and no perioperative death.According to the preoperative data statistics of the two groups,age,sex,liver function,tumor size,and number were not significantly different(P>0.05),indicating that the two groups were well-balanced and comparable.In preoperative doctor-patient communication,Patients in the MR group had higher satisfaction than the NMR group,statistically significant(Z=-3.857,P <0.001),while there was no significant difference in understanding(Z=-0.244,P=0.807).Intraoperative conditions,operative time,and intraoperative bleeding were 170(123)min and 125(268)ml,significantly less than 300(183)min and 250(550)ml in the NMR group(Z=-4.182,-2.287;P <0.05).The postoperative transfusion rate in the MR group was 17%(5 / 30),which was significantly lower than 37%(11 / 30),which was statistically significant(χ~2=5.079,P <0.05).Postoperative status,postoperative length of hospitalization 8(6)d,was significantly shorter than 11(5)d in the NMR group(Z=-3.120,P=0.002).The postoperative complication rates in the MR and NMR groups were 37%(11 / 30)and 53%(16 / 30)but not significant(χ~2=1.684,P=0.194).Postoperative pathology among 60 patients: 49 hepatocellular carcinoma,6 cholangiocellular carcinoma,and 5 hepatic hemangioma.Follow-up: 3 to 24 months,median follow-up of 9 months.During the follow-up period,15 tumors recurred,including 6 in the MR group and 9 in the NMR group,which were insignificant(χ~2=0.800,P=0.371).Conclusion:The mixed reality group was better than the non-mixed reality group in terms of operation time,intraoperative blood loss,intraoperative blood transfusion rate,and postoperative hospital stay length;patients in MR group are better than NMR group in satisfaction of doctor-patient communication quality;Mixed reality can clearly show the relationship between tumor and surrounding pulse vessels,facilitate doctors to observe and analyze,monitor and evaluate the execution of the resection plan in real time,guide the operation more accurately,and improve the operation efficiency and quality.In patients with laparoscopic hepatectomy based on three-dimensional reconstruction,intraoperative navigation using mixed reality technology helps to improve the precision,safety and feasibility of the operation.