Computer-assisted Navigation Research Articles

Predictors of tract hemorrhage after external ventricular drain placement: a single-center retrospective study.

External ventricular drain (EVD) placement is often associated with complications; however, predictors of adverse outcomes after EVD placement are not well understood. This study aimed to identify predictors of EVD tract hemorrhage and to compare post-EVD hemorrhage rates between computer-assisted navigation and freehand technique EVD placement. This retrospective study included 147 consecutive patients who presented with increased intracranial pressure (ICP) requiring an EVD. Multivariable logistic regression was used to assess the relationship between predictors and adverse outcomes after EVD placement. The most common presenting pathologies in patients who had EVD placement were intraparenchymal hemorrhage (IPH) (43%) and subarachnoid hemorrhage (SAH) (28%). 14% of patients experienced EVD tract hemorrhage. Patients with platelet counts < 120 × 10³/µL (OR = 4.47, 95% CI = 1.01-20, p = 0.038), white blood cell counts < 11 × 10³/µL (OR = 3.3, 95% CI = 1.01-10.7, p = 0.048), and IPH (OR = 2.97, 95% CI = 1.06-10.7, p = 0.048) had increased risks of tract hemorrhage. The use of computer-assisted navigation did not reduce the risk of tract hemorrhage after EVD placement compared to the freehand technique. This study identified factors associated with increased risks of hemorrhage after EVD placement, which can help triage at-risk patients and reduce adverse outcomes of this procedure.

Evaluating the References of Insurance Policies for Computer-Assisted Navigation in Total Knee Arthroplasty Compared With the American Academy of Orthopaedic Surgeons Clinical Practice Guideline.

This study aimed to investigate the quality and quantity of sources cited by insurance payers for computer-assisted navigation (CAN) in total knee arthroplasty (TKA) and to compare these sources with those cited by the American Academy of Orthopaedic Surgeons (AAOS) Clinical Practice Guideline (CPG). References were included from insurance payer policies on CAN that discussed the use of CAN in TKA, while every reference from the AAOS CPG for surgical navigation in TKA was included. Fifty-four unique articles from insurance payers met criteria, with 68.5% being primary journal articles and 18.5% being reviews. The quality of cited studies was relatively evenly distributed between level of evidence (LOE) I/II (42.6%) and LOE III and below (50.0%). The 14 references cited in the AAOS CPG were 100% primary articles and 100% LOE I/II. Only 16.3% of cited insurance references were AAOS CPG articles. Nine of the 14 AAOS CPG studies were not cited by any of the insurance payer policies. Compared with the AAOS CPG, insurance policies cited older articles with lower LOE. We recommend continued updating of the AAOS CPG and insurance policies as more research into the use of CAN in TKA is published. [Orthopedics. 202x;4x(x):xx-xx.].

Utilization of Computer-Assisted Navigation Technology Within Craniomaxillofacial Fracture Surgery: A Systematic Review.

Use of intraoperative computer-assisted navigation (iCAN) has been well-established in otolaryngology and neurosurgery; however, its use in surgical management of facial fractures is yet to be reported on a large scale. This study aimed to review the existing literature to determine the outcomes, limitations, risks, and benefits of iCAN use in facial fracture management. A systematic review of iCAN use in craniomaxillofacial fracture surgery was performed by 2 authors in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search was conducted on 3 databases, PubMed, Cochrane Library, and Embase, using the search terms "navigation," "intraoperative," and "brain lab" in combination with "facial fractures" or "facial reconstruction." Study type, demographics, fracture characteristics, surgery characteristics, iCAN devices, intraoperative fracture fixation accuracy, postoperative outcomes, complications, navigation limitations, and risks and benefits were analyzed. There were 909 studies identified in the initial search, of which 42 were chosen for final use. iCAN use was most commonly reported in unilateral (57.1%) and complex (50%) facial fracture cases. Surgical accuracy ranged from 0.7 to 4 mm and postoperative discrepancy ranged from 0.05 to 8 mm. Benefits included improved intraoperative surgical accuracy (95.2%), improved postoperative surgical discrepancy (52.4%), and decreased total surgical time (35.7%). Limitations reported with iCAN device use included operative technical difficulties (23.8%) and persistent systematic errors during device registration (21.4%). None of the studies discussed cost analysis or risks compared to conventional fixation methods. Advancements in and increasing familiarity with iCAN technology have preliminarily shown favorable surgical outcomes in facial fracture fixation, which include improved operative accuracy and discrepancy and decreased surgical time.

Evaluating Alternative Registration Planes in Imageless, Computer-Assisted Navigation Systems for Direct Anterior Total Hip Arthroplasty.

(1) Background: Imageless computer navigation systems have the potential to improve the accuracy of acetabular cup position in total hip arthroplasty (THA). Popular imageless navigation methods include locating the patient in a three-dimensional space (registration method) while using a baseline to angle the acetabular cup (reference plane). This study aims to compare the accuracy of different methods for determining postoperative acetabular cup positioning in THA via the direct anterior approach. (2) Methods: Fifty-one participants were recruited. Optical and inertial sensor imageless navigation systems were used simultaneously with three combinations of registration methods and reference planes: the anterior pelvic plane (APP), the anterior superior iliac spine (ASIS) and the table tilt (TT) method. Postoperative acetabular cup position, inclination, and anteversion were assessed using CT scans. (3) Results: For inclination, the mean absolute error (MAE) was lower using the TT method (2.4° ± 1.7°) compared to the ASIS (2.8° ± 1.7°, p = 0.17) and APP method (3.7° ± 2.1°, p < 0.001). For anteversion, the MAE was significantly lower for the TT method (2.4° ± 1.8°) in contrast to the ASIS (3.9° ± 3.2°, p = 0.005) and APP method (9.1° ± 6.2°, p < 0.001). (4) Conclusion: A functional reference plane is superior to an anatomic reference plane to accurately measure intraoperative acetabular cup inclination and anteversion in THA using inertial imageless navigation systems.

Comparison of Implant Placement Accuracy Between Manual, Robot-Assisted, Computer-Navigated, Augmented Reality Navigated, Patient-Specific Instrumentation, and Accelerometer Navigated Total Hip Arthroplasty: A Systematic Review and Network Meta-Analysis.

Malpositioning of the acetabular cup during total hip arthroplasty (THA) can lead to complications. Robotic surgery and navigation techniques aim to address this issue, but there is limited evidence regarding which method can achieve better clinical outcomes. Therefore, this network meta-analysis (NMA) aimed to compare the efficacy of various navigation methods. This NMA of prospective randomized controlled trials compared robot-assisted systems (RAS), computer-assisted navigation systems (CAS), augmented reality-based portable navigation (AR), patient-specific instrumentation (PSI), portable accelerometer-based navigation (PN), and conventional methods (C) for THA procedures. We searched MEDLINE, EMBASE, Cochrane, Central Register of Controlled Trials, International Clinical Trials Platform Search Portal, and ClinicalTrials.gov. databases. The primary outcomes included revision surgery and postoperative clinical scores, and the secondary outcomes encompassed cup placement accuracy, acetabular cup placement outliers from the Lewinnek safe zone, surgical time, and complications. We used a Bayesian random-effects NMA, and confidence of evidence was assessed using confidence in NMA. We identified 45 studies including 2,122 patients. We did not find large differences in revision surgery, clinical outcome scores, cup inclination, or anteversion angle accuracy among the modalities. AR, CAS, and PSI exhibited a lower risk of outliers from safe zones than C. In addition, RAS and CAS had a longer surgical time than C. Robotic and navigation tools did not reduce the revision risk or enhance clinical outcomes. AR, CAS, PSI, and PN may decrease the risk of cup placement outliers in safe zones. However, the cup placement accuracy was equivalent, and the surgical time may be longer in RAS and CAS than in C. Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Development and application of digital technology in craniomaxillofacial surgery

The treatment of craniomaxillofacial (CMF) defects and deformities is highly challenging due to the complex anatomical structures, significant individual variations and high demands for personalized reconstruction. In recent decades, the integration of cutting-edge technologies from fields such as computer science, mechanical engineering, and material science into medicine has greatly facilitated the transformation of CMF surgery from traditional, experience-based approaches to digitalized and intelligent methods. This review thoroughly analyzes the development and application areas of digital technology in CMF surgery including virtual surgical planning and facial prediction, three-dimensional printing, computer-assisted navigation and robotic surgery, virtual and mixed reality, as well as big data and artificial intelligence technologies. The aim is to offer comprehensive and in-depth reference information for the clinical practice in digital CMF surgery.

Early Hip Dislocation Rate in a Consecutive Series of 1093 Primary Total Hip Arthroplasties Using Imageless Navigation

Purpose: Postoperative hip dislocation remains a major complication in total hip arthroplasty. Various studies have demonstrated that several factors influence dislocation. While computer-assisted navigation has been proposed to enhance component alignment, its impact on dislocation rates remains unclear. This study aimed to investigate the early dislocation incidence and associated risk factors in primary total hip arthroplasty (THA) using imageless navigation. Methods: A retrospective review of patients undergoing imageless-navigated THA between February 2013 and December 2022 was conducted. Inclusion criteria comprised primary THA with a minimum 6-month follow-up. Statistical analysis included univariate regression to identify dislocation risk factors. Results: A total of 1093 THAs were analyzed. Dislocation occurred in 16 cases (1.5%), six in elective procedures (0.76%), and 10 in femoral neck fracture (FNF) (3.28%). The univariate regression analysis revealed that FNF emerged as a significant risk factor (OR = 4.418, P = 0.004), while age, gender, femoral head size, and save zone cup placement of Lewinnek did not significantly affect dislocation rates. Conclusions: Navigation use showed a reduced rate of early dislocation. FNF is a factor associated with postoperative hip dislocation in primary THA.

The effect of computer aided navigation techniques on the precision of endodontic access cavities: A systematic review and meta-analysis

AIM. To assess the impact of computer-assisted navigation techniques on the precision of endodontic access cavity preparation.MATERIALS AND METHODS. A systematic review was conducted following the PRISMA 2020 guidelines. Articles were searched for online using electronic databases, including Scopus, PubMed, Cochrane, and Web of Sciences. The success rate of root canal location using computer-aided navigation techniques in root canal access cavity preparation, along with the time required for cavity preparation and the extent of tooth substance removal were assessed in this review. After eliminating duplicate articles and applying inclusion criteria, 10 studies were chosen for analysis.RESULTS. Accuracy in location of root canal is significantly higher in the static and dynamic navigation group compared to the conventional group. Also, computer-aided static and dynamic navigation techniques removed significantly less tooth substance compared to conventional groups. Moreover, static navigation technique took significantly less time for access cavity preparation than conventional while there was no significant difference in the time taken for access cavity preparation between dynamic navigation technique and conventional technique.CONCLUSION. The root canal access cavities prepared using static and dynamic computer-aided navigation techniques are highly precise in detecting the root canal system, require less tooth substance removal, and take less time to complete.

Manoeuvring in shallow and confined water with model predictive track controllers

Abstract Autonomous and computer-assisted navigation, for example through portable pilot units and data-driven decision supportive systems, is in full development. Remote-controlled vessels (manned but without a captain steering continuously on board) are used in Belgium (by Seafar in inland shipping) but also in other countries. A model predictive controller has been used to investigate environmental and operational parameters for the passage of the river Seine in Paris by different ship types. These fast-time simulations have been compared with simulations in real time executed by skippers on a ship manoeuvring simulator or measured real life tracks. A good predictability of the real situation requires accurate manoeuvring models. But what if this accuracy cannot be guaranteed? An illustration is made by comparing the tracks if, in the prescience prediction phase for the controller, wind or bank effects are neglected or doubled. The development of model predictive deep reinforcement learning control algorithms for navigation will be one of the challenges of the Data-driven Smart Shipping project that started May 2024.

Technique, Safety, and Accuracy Assessment of Percutaneous Pedicle Screw Placement Utilizing Computer-Assisted Navigation in Lateral Decubitus Single-Position Surgery.

Percutaneous pedicle screw (PPS) placement has become a pivotal technique in spinal surgery, increasing surgical efficiency and limiting the invasiveness of surgical procedures. The aim of this study was to analyze the accuracy of computer-assisted PPS placement with a standardized technique in the lateral decubitus position. A retrospective review of prospectively collected data was performed on 44 consecutive patients treated between 2021 and 2023 with lateral decubitus single-position surgery. PPS placement was assessed by computed tomography scans, and breaches were graded based on the magnitude and direction of the breach. Facet joint violations were assessed. Variables collected included patient demographics, indication, intraoperative complications, operative time, fluoroscopy time, estimated blood loss, and length of stay. Forty-four patients, with 220 PPSs were identified. About 79.5% of all patients underwent anterior lumbar interbody fusion only, 13.6% underwent lateral lumbar interbody fusion only, and 6.8% received a combination of both anterior lumbar interbody fusion and lateral lumbar interbody fusion. Eleven screw breaches (5%) were identified: 10 were Grade II breaches (<2 mm), and 1 was a Grade IV breach (>4 mm). All breaches were lateral. About 63.6% involved down-side screws indicating a trend toward the laterality of breaches for down-side pedicles. When analyzing breaches by level, 1.2% of screws at L5, 13% at L4, and 11.1% at L3 demonstrated Grade II breaches. No facet joint violations were noted. PPS placement utilizing computer-assisted navigation in lateral decubitus single-position surgery is both safe and accurate. An overall breach rate of 5% was found; considering a safe zone of 2 mm, only 1 screw (0.5%) demonstrated a relevant breach. PPS placement is both safe and accurate. Breaches are rare, and when breaches do occur, they are lateral.

Progress in Computer-Assisted Navigation for Total Knee Arthroplasty in Treating Knee Osteoarthritis with Extra-Articular Deformity.

Total knee arthroplasty (TKA) is a well-established treatment for end-stage knee osteoarthritis. However, in patients with concomitant extra-articular deformities, conventional TKA techniques may lead to unsatisfactory outcomes and higher complication rates. This review summarizes the application of navigated TKA for treating knee osteoarthritis with extra-articular deformities. The principles and potential benefits of computer navigation systems, including improved component alignment, soft tissue balancing, and restoration of mechanical axis, are discussed. Research studies demonstrate that navigated TKA can effectively correct deformities, relieve pain, and improve postoperative joint function and quality of life compared with conventional methods. The advantages of navigated TKA in terms of surgical precision, lower complication rates, and superior functional recovery are highlighted. Despite challenges like the learning curve and costs, navigated TKA is an increasingly indispensable tool for achieving satisfactory outcomes in TKA for knee osteoarthritis patients with extra-articular deformities.

Robotic-Assisted Total Knee Arthroplasty Results in Shorter Navigation Working Time With Similar Clinical Outcomes Compared to Computer-Navigated Total Knee Arthroplasty

BackgroundEarly clinical data are important in the appraisal of newly introduced robotic-assisted surgery (RAS) systems in total knee arthroplasty (TKA). However, there are few studies to date comparing 1-year clinical outcomes between RAS and computer-assisted navigation (CAS), the forerunner in reducing alignment outliers. The aim of this study was to determine if there was a difference between these two groups in early clinical outcomes, including functional outcome and patient-reported outcome measures (PROMs). MethodsA total of 158 propensity score-matched patients who underwent primary TKA with either CAS or RAS were retrospectively analyzed. Perioperative outcomes (navigation time, length of stay, complications, readmissions, transfusions, and technical failure), as well as functional outcome measures (range of motion, sit to stand test, timed-up-and-go test, single-leg stance test, calf raises, and step count), and PROMs (Oxford Knee Score, Knee Injury and Osteoarthritis Outcome Score, 12-item Short Form Survey, Forgotten Joint Score-12, and satisfaction) were compared between those who underwent CAS and those who underwent RAS. ResultsNavigation time was shorter in the RAS group compared to the CAS group (mean difference, 15.4 minutes; P < 0.001). There were 2 complications reported in the CAS group (one patellar clunk, one periprosthetic joint infection), but none in the RAS group. There were no other readmissions, transfusions, or technical failures in either group. Postoperatively, there were no clinical differences in function between groups. Clinically meaningful improvement in PROMs was observed in both groups, with no differences. ConclusionsThe use of RAS resulted in shorter navigation time compared to CAS in TKA. No other differences were observed in early clinical outcomes between patients who underwent RAS and CAS.

LEADING-EDGE DEVELOPMENTS IN GUIDED ENDODONTICS: UTILIZING NEXT-GENERATION TOOLS

Guided endodontics has revolutionized root canal therapy by integrating advanced technologies to improve precision, safety, and outcomes. This method combines imaging technologies like cone beam computed tomography (CBCT) with computer-assisted navigation systems to enhance the accuracy of root canal treatments. Key stages include initial diagnostic imaging, 3D virtual treatment planning, and the use of customized guides or templates during procedures. These guides help accurately identify canal orifices, reducing procedural errors and improving access to complex root structures. Benefits include better treatment predictability, reduced procedure time, and lower risk of complications. Recent advancements, such as high-resolution CBCT, advanced 3D printing for custom guides, and improved virtual planning, have enhanced the precision of access cavity preparations. Innovations like low-profile clinical templates address challenges with restricted mouth openings, while improved intraoral scanning and virtual planning streamline preparation processes. Despite higher costs and increased planning time, guided endodontics is increasingly seen as a standard method, offering substantial improvements in clinical practice and patient outcomes. This review consolidates these advancements, emphasizing their impact on precision, efficiency, and future research directions in endodontics.

Does Pedicle Morphology Affect the Safety and Accuracy of Pedicle Screw Placement Using 3D-Printed Guides? A 5-Year, Single-Center Experience With 2210 Screws Placed for Adult Spinal Deformity Reconstruction.

Adult spinal deformity (ASD) surgery often involves the placement of pedicle screws using various methods, including freehand technique, fluoroscopic guidance, and computer-assisted intraoperative navigation, each with distinct limitations. Particularly challenging is the instrumentation of pedicles with small or absent cancellous channels (Watanabe types C and D pedicles), commonly found at the apex of large curves where precise screw placement is crucial for effective deformity correction. 3D-printed pedicle screw drill guides (3DPSG) may assist in accurately placing pedicle screws while minimally disrupting the standard ASD surgery workflow. This study aims to evaluate the safety and efficacy of 3DPSG in ASD patients with Watanabe types C and D pedicles, where the safe corridor for screw placement is limited. 3DPSG were designed using fine cut (≤1.25 mm) computed tomography scans. Preoperative screw trajectory planning and guide manufacturing were conducted using computer-aided design software (Mighty Oak Medical, Englewood, CO). Four ASD surgeons with varying experience levels placed the guides. Data on patient demographics, pedicle morphology, number of levels instrumented, and implant-related complications were collected. The study included 115 patients (median age 67, range 18-81 years) with 2210 screws placed from T1 to L5. The median number of levels instrumented per case was 11 (range 7-12). Diagnoses included adult degenerative scoliosis (n = 62), adult idiopathic scoliosis (n = 30), Scheuermann's kyphosis (n = 2), and other complex conditions (n = 21). The overall accuracy rate for pedicle screw placement was 99.5%, with a 0% malposition rate in type C and D pedicles. No vascular or neurological complications or reoperations related to screw placement were reported. 3DPSG facilitates safe and accurate pedicle screw placement regardless of pedicle morphology in ASD surgeries. This includes the challenging Watanabe types C and D pedicles, typically found at curve apices, enabling surgeons to achieve high implant density and optimal spinal fixation in ASD patients.

Use of Augmented Reality as a Radiation-free Alternative in Pain Management Spinal Surgeries

Recent advancements in computer-assisted surgical navigation have enhanced imaging precision while reducing fluoroscopy reliance. However, integrating these systems into outpatient interventional pain practices remains costly. This paper investigates a cost-effective Augmented Reality (AR) navigation system tailored for image-guided spinal pain procedures. We verify the feasibility of AR in spinal surgery and the potential of AR to replace fluoroscopy.

Endoscopic resection of primary sinonasal mucosal melanoma with orbital invasion: How I do it

Primary sinonasal mucosal melanoma is a rare aggressive malignancy. In this video, a case of a 68-year-old female who presented with diplopia for 2 weeks is described. The present video reports the endoscopic endonasal surgical excision of a primary sinonasal mucosal melanoma. The video contains patient's medical history, preoperative radiological evaluations and step-by-step description of surgical steps of the procedure with the utilization of computer-assisted navigation system.

Osteochondroma at the Ventro-Medial Surface of the Scapula Causing Pseudo Winging Scapular Resection with Computer-Assisted Navigation: A Case Report and Literature Review

Purpose: Osteochondromas, the most common benign bone tumors, primarily occur in the long bones, with scapular osteochondromas constituting less than 1% of cases. A unique challenge in ventral scapular osteochondromas is limited visibility from the dorsal side. Computer-assisted surgery, which is widely employed in tumor surgery is a promising solution for minimally invasive resection with reduced muscle injury. Methods: We present the case of a thirteen-year-old female with a ventral scapular osteochondroma that cause winging and snaping of her left arm. The patient underwent computer-assisted surgery under general anesthesia in the prone position. The procedure involved a minimal incision over the crest of the scapular spine, enabling precise identification of the tumor from the dorsal side using navigation tools. Results: The tumor, identified as an osteochondroma on CT scans, was successfully resected with minimal soft tissue damage. Postoperatively, the patient's arm was immobilized for two weeks, followed by a pain-free return to normal activity. Radiographic evaluation confirmed complete tumor removal. Conclusions: Computer-assisted navigation can help locate the ventral osteochondroma of the scapula with minimal soft tissue damage and a quicker recovery time.

Sacropelvic Fixation with Porous Fusion/Fixation Screws: A Technical Note and Retrospective Review

ObjectiveThe goal of this study was to analyze our initial experience using a novel porous fusion/fixation screw (PFFS) for pelvic fixation, and to determine our rate of screw malposition requiring intraoperative repositioning. MethodsWe reviewed 83 consecutive patients who underwent sacropelvic fixation with PFFS at our institution from 6/1/2022-6/30/2023 using intraoperative CT-based computer-assisted navigation (CAN) via an open posterior approach. Following PFFS insertion, intraoperative CT scans were obtained to assess screw positioning. Demographic data was collected, and operative reports and patient images were reviewed to determine what implants were used and if any PFFS required repositioning. Results74 patients (26M:48F) were included, and 57 (77.0%) had a prior sacroiliac joint or lumbar spine surgery. A stacked screw configuration was used in 62/74 cases (83.8%). A total of 235 PFFS were used and six (2.6%) were malpositioned. Of 88 cephalic screws placed in stacked configuration, 4 were malpositioned (4.5%); and 1/123 caudal screws were malpositioned (0.8%). One of 24 SAI screws placed in a stand-alone configuration was malpositioned (4.2%). Malpositions included four medial, one lateral, and one inferior; and all were revised intraoperatively without major sequela. ConclusionsAlthough PFFS are larger than traditional sacropelvic fixation screws, stacked SAI instrumentation can be done safely with CAN. We found a low malposition rate in our initial series of patients, the majority being the cephalad screw in a stacked configuration. This isn’t surprising, as these are placed after the caudal screws which reduces the available corridor size and increases the placement difficulty.

Real-time deformable SLAM with geometrically adapted template for dynamic monocular laparoscopic scenes.

Intraoperative reconstruction of endoscopic scenes is a key technology for surgical navigation systems. The accuracy and efficiency of 3D reconstruction directly determine the effectiveness of navigation systems in a variety of clinical applications. While current deformable SLAM algorithms can meet real-time requirements, their underlying reliance on regular templates still makes it challenging to efficiently capture abrupt geometric features within scenes, such as organ contours and surgical margins. We propose a novel real-time monocular deformable SLAM algorithm with geometrically adapted template. To ensure real-time performance, the proposed algorithm consists of two threads: a deformation mapping thread updates the template at keyframe rate and a deformation tracking thread estimates the camera pose and the deformation at frame rate. To capture geometric features more efficiently, the algorithm first detects salient edge features using a pre-trained contour detection network and then constructs the template through a triangulation method with guidance of the salient features. We thoroughly evaluated this method on Mandala and Hamlyn datasets in terms of accuracy and performance. The results demonstrated that the proposed method achieves better accuracy with 0.75-7.95% improvement and achieves consistent effectiveness in data association compared with the closest method. This study verified an adaptive template does improve the performance of reconstruction of dynamic laparoscopic Scenes with abrupt geometric features. However, further exploration is needed for applications in laparoscopic surgery with incisal margins caused by surgical instruments. This research serves as a crucial step toward enhanced automatic computer-assisted navigation in laparoscopic surgery. Code is available at https://github.com/Tang257/SLAM-with-geometrically-adapted-template .

Minimally invasive intelligent innovative technologies in foot and ankle surgery: development status and prospects

The rapid development of technology has ushered in a new era of minimally invasive and intelligent surgery.Minimally invasive surgeries, such as small incision, percutaneous surgery, arthroscopic surgery, and endoscopic surgery, have contributed to less invasive surgical trauma, better cosmesis, and faster recovery. Furthermore, the recent adoption of artificial intelligence (AI) has introduced new assistances and tools for minimally invasive foot and ankle surgery. By the help of advanced AI algorithms, surgeons can accurately make diagnose and personalized treatment strategies. The application of computer-assisted navigation systems and robotics has facilitated precise surgical procedures and real-time confirmation of surgical outcomes. Foot and ankle surgery has lagged behind other surgical specialties in adopting these advancements. Currently, the integration of various forms of minimally invasive surgery and AI technology stands as the main trend in the development of foot and ankle surgery. It is believed that in the near future, intelligent minimally invasive surgery will become the mainstream in the domain of foot and ankle.