Augmented reality-assisted navigation system contributes to better intraoperative and short-time outcomes of laparoscopic pancreaticoduodenectomy: a retrospective cohort study.

Abstract

Augmented reality-assisted navigation system (AR-ANS) are currently good techniques for hepatectomy, however its application and efficacy for laparoscopic pancreatoduodenectomy have not been reported. This study sought to focus on and evaluate the advantage of laparoscopic pancreatoduodenectomy guided by the AR-ANS in intraoperative and short-time outcomes. Eighty-two patients who underwent laparoscopic pancreatoduodenectomy from January 2018 to May 2022 were enrolled and divided into the AR and non-AR groups. Clinical base-line features, operation time, intraoperative blood loss, blood transfusion rate, perioperative complications and mortality were analyzed. Augmented reality-guided laparoscopic pancreaticoduodenectomy was performed in the AR group (n=41), whereas laparoscopic pancreatoduodenectomy was carried out routinely in the non-AR group (n=41). There was no significant difference in baseline data between the two groups (P>0.05); Although the operation time of the AR group was longer than that of the non-AR group (420.15±94.38 vs. 348.98±76.15, P<0.001), the AR group had a less intraoperative blood loss (219.51±167.03 vs. 312.20±195.51, P=0.023), lower blood transfusion rate(24.4% vs. 65.9%, P<0.001), lower occurrence rates of postoperative pancreatic fistula(12.2% vs. 46.3%, P=0.002) and bile leakage(0% vs. 14.6%, P=0.026), and shorter postoperative hospital stay (11.29±2.78 vs. 20.04±11.22, P<0.001) compared with the non-AR group. Augmented reality-guided laparoscopic pancreatoduodenectomy has significant advantages in identifying important vascular structures, minimizing intraoperative damage, and reducing postoperative complications, suggesting that it is a safe, feasible method with a bright future in the clinical setting.