Surgical Navigation Technology Research Articles

A simple “spraying” fluorescence‐guided surgery by AIE probes for liver tumor resection through configuration‐induced cross‐identification

AbstractSurgical resection is the preferred option for hepatocellular carcinoma (HCC), but surgical navigation technology using indocyanine green still has some drawbacks such as non‐specific imaging, thus it is very important to develop new fluorescence imaging technology. All‐cis hexaphenyl‐1,3‐butadiene derivative (ZZ‐HPB‐NC) with aggregation‐induced emission (AIE) feature has been reported to be quickly turned‐on fluorescent response in the intraoperative frozen‐section slides of HCC. However, the probe did not respond to normal liver tissue around HCC. In order to enhance the diagnostic rate and elucidate the response mechanism, all‐trans configuration EE‐HPB‐NC, was furtherly synthesized. Within two minutes, non‐cancer tissues could be fluorescently labeled by EE‐HPB‐NC by spraying, showing the same effect with ZZ‐HPB‐NC to HCC. The results indicated that the configuration‐induced cross‐identification fluorescence imaging strategy was achieved through the combination of ZZ‐ and EE‐HPB‐NC. Then the mechanism of HPB‐NC localization in HCC lesions was explored, and the binding of HPB‐NC with specific proteins in cells resulted in the AIE effect to label HCC cells. On this basis, the accuracy of specific fluorescence imaging for HCC was further verified on the mouse hepatic neoplasm models, indicating that it has clinical application potential for surgical fluorescence real‐time navigation.

Effect of augmented reality navigation technology on perioperative safety in partial nephrectomies: A meta-analysis and systematic review.

To evaluate the impact of augmented reality surgical navigation (ARSN) technology on short-term outcomes of partial nephrectomy (PN). A systematic literature search was conducted in PubMed, Embase, Cochrane, and Web of Science for eligible studies published through March 28, 2022. Two researchers independently performed the article screening, data extraction and quality review. Data analysis was performed using Cochrane Review Manager software. A total of 583 patients from eight studies were included in the analysis, with 313 in the ARSN-assisted PN group (AR group) and 270 in the conventional PN group (NAR group). ARSN-assisted PN showed better outcomes than conventional surgery in terms of operative time, estimated blood loss, global ischemia rate, warm ischemia time, and enucleation rate. However, there were no significant differences in the rate of Conversion to radical nephrectomy (RN), postoperative estimated glomerular filtration rate (eGFR), positive margin rate, and postoperative complication rate. The utilization of ARSN can improve the perioperative safety of PN. Compared with conventional PN, ARSN-assisted PN can reduce intraoperative blood loss, shorten operative time, and improve renal ischemia. Although direct evidence is lacking, our results still suggest a potential advantage of ARSN in improving renal recovery after PN. However, as the ARSN system is still in an exploratory stage, its relevance in PN have been poorly reported. Additional high-quality randomized controlled trial (RCT) studies will be required to confirm the effect of ARSN on PN. https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=301798, identifier PROSPERO ID: CRD42022301798.

Skull-Base Surgery—A Narrative Review on Current Approaches and Future Developments in Surgical Navigation

Surgical navigation technology combines patient imaging studies with intraoperative real-time data to improve surgical precision and patient outcomes. The navigation workflow can also include preoperative planning, which can reliably simulate the intended resection and reconstruction. The advantage of this approach in skull-base surgery is that it guides access into a complex three-dimensional area and orients tumors intraoperatively with regard to critical structures, such as the orbit, carotid artery and brain. This enhances a surgeon's capabilities to preserve normal anatomy while resecting tumors with adequate margins. The aim of this narrative review is to outline the state of the art and the future directions of surgical navigation in the skull base, focusing on the advantages and pitfalls of this technique. We will also present our group experience in this field, within the frame of the current research trends.

What Is Next in Computer-Assisted Spine Surgery? Advances in Image-Guided Robotics and Extended Reality

Background: This article provides a scoping review on the current status of Image-Guided Navigation with various forms of digital technologies, including Extended Reality, Augmented Reality Head-Mounted Displays (AR–HMDs) and Robot-Assisted Surgery (RAS) for Pedicle Screw Placement in orthopedics and spine surgery. Methods: A scoping literature review was performed in the PubMed, Scopus, Embase, Web of Science, Google Scholar and IEEE Xplore databases to collect clinical and user satisfaction data on AR–HMDs and compare those with RAS outcomes. In vivo patient, cadaver and phantom trial accuracy data reports were identified and grouped through the analysis. Over the past two years, 14 publications were retrieved and analyzed. Pedicle screw placement accuracy was described with Linear Tip Error (LTE), Angular Trajectory Error (ATE) and Gertzbein–Robbins Scale (GRS) outcomes. Results: The Pedicle Screw Placement accuracy was seen to increase in the in vivo, cadaver and phantom model groups using AR-HMD compared to the Free-Hand insertion technique. User experience and satisfaction data were limited; however, a clear advantage for the operative results was described when it was added. RAS screwing showed similar accuracy outcomes. The need for benchmarking and quantified situation awareness for AR–HMDs is recognizable. The authors present a method for standardized scoring and visualization of surgical navigation technologies, based on measurements of the surgeon (as the end-users) user satisfaction, clinical accuracy and operation time. Conclusions: computer-technology driven support for spine surgery is well-established and efficient for certain procedures. As a more affordable option next to RAS, AR–HMD navigation has reached technological readiness for surgical use. Ergonomics and usability improvements are needed to match the potential of RAS/XR in human surgeries.

Information loss challenges in surgical navigation systems: From information fusion to AI-based approaches

Surgical navigation technology provides minimally invasive surgery (MIS) with the relative pose relationships amongst medical images, surgical instruments, and lesions. On the other hand, traditional operation procedures depend heavily on direct surgical field exposure. Consequently, introducing surgical navigation can enable surgeons to operate more accurately and efficiently. A tracking system is a core enabling technology of a surgical navigation system. In this paper, after reviewing the tracking technologies, we compare and analyze their pros and cons, and find that information loss is a common challenge. The information loss problem is an inherent drawback in mono-modality surgical navigation systems. It is characterized by physical constraints, attenuation, breakdown of signal, and accuracy instability of the tracking algorithms. This review focuses on the information loss problem in tracking technologies for surgical navigation systems. Furthermore, we survey the existing solutions that aim at tackling the information loss problem, especially in the information fusion of surgical tracking technologies, and we also summarize their key improvements and limitations. Particular attention has been given to the modalities, approaches, objectives, and surgical application scenarios, which can improve the accuracy, precision, and stability of surgical navigation systems. Finally, future research trends directed at improving the information loss problem are discussed, i.e., tight integration of sensing technology, augmented reality for visualization in surgical tracking, stable high-speed 5G networks for telesurgery, strong intelligence and affordable service.

AN INTRAOPERATIVE CORRECTION METHOD OF MAXILLOFACIAL SURGERY BASED ON LASER SCANNER

The oral craniomaxillofacial region is adjacent to the cranium with complex anatomical structures. Therefore, precise and minimally invasive surgeries are essential for preserving its function and reconstructing its appearance. The most commonly used method is optical surgical navigation technology. Compared with preoperative computed tomography image registration, the accuracy of intraoperative navigation can be calculated to help surgeons judge the effect of surgery. This study aimed to introduce laser scanning in craniomaxillofacial bone surgery, so as to create a new method of navigation accuracy verification, and compare the image with the preoperative plan. The experimental results of this study showed that the average accuracy of point verification calculation was greater than 3[Formula: see text]mm, which was much greater than the average accuracy of laser scanning plane verification based on mixed Student [Formula: see text] distribution (less than 1[Formula: see text]mm), and a statistically significant difference was found between them. It was demonstrated that relying solely on individual points to depict the operation of the entire bone surface was insufficient in navigation surgery.

Identifying Trends and Quantifying Growth for Technological Innovation in Knee Arthroplasty: An Analysis of a Patent Database (1990 to 2020).

Technological innovation is the key for surgical progress in knee arthroplasty and improvement in patient outcomes. Exploring patented technologies can help elucidate trends and growth for numerous innovative technologies. However, patent databases, which contain millions of patents, remain underused in arthroplasty research. Therefore, the present study aimed to: (1) quantify patent activity; (2) group patents related to similar technologies into well-defined clusters; and (3) compare growth between technologies in the field of knee arthroplasty over a 30-year period. An open-source international patent database was queried from January 1990 to January 2020 for all patents related to knee arthroplasty A search strategy identified 70,154 patents, of which 24,425 were unique and included analysis. Patents were grouped into 14 independent technology clusters using Cooperative Patent Classification (CPC) codes. Patent activity was normalized via a validated formula adjusting for exponential growth. Compound annual growth rates (CAGR) were calculated (5-year, 10-year, and 30-year CAGR) and compared for each cluster. Overall yearly patent activity increased by 2,023%, from 104 patents in 1990 to 2,208 patents in 2020. The largest technology clusters were "drugs" (n = 5,347; 23.8%), "components" (n = 4,343; 19.0%), "instruments" (n = 3,130; 13.7%), and "materials" (n = 2,378; 10.4%). The fastest growing technologies with their 5-year CAGR were: "user interfaces for surgical systems" (58.1%); "robotics" (28.6%); "modularity" (21.1%); "navigation" (15.7%); and "computer modeling" (12.5%). Since 1990, overall patent growth rate has been greatest for "computer modeling" (8.4%), "robotics" (8.0%), "navigation" (7.9%), and "patient-specific instrumentation" (6.4%). Most patents in knee arthroplasty for the last 30 years have focused on drugs, components, instruments, and materials. Recent exponential growth was mainly observed for user interfaces for surgical systems, robotics, modularity, navigation, and computer-assisted technologies. Innovation theory would suggest that these rapidly growing technologies are experiencing high innovation output, increased resource investments, growing adoption by providers, and significant clinical impact. Periodic monitoring of technological innovation via patent databases can be useful to establish trends and future directions in the field of knee arthroplasty.

Validation of an RF Image System for Real-Time Tracking Neurosurgical Tools.

A radio frequency (RF)-based system for surgical navigation is presented. Surgical navigation technologies are widely used nowadays for aiding the surgical team with many interventions. However, the currently available options still pose considerable limitations, such as line-of-sight occlusion prevention or restricted materials and equipment allowance. In this work, we suggest a different approach based on a microwave broadband antenna system. We combine techniques from microwave medical imaging, which can overcome the current limitations in surgical navigation technologies, and we propose methods to develop RF-based systems for real-time tracking neurosurgical tools. The design of the RF system to perform the measurements is shown and discussed, and two methods (Multiply and Sum and Delay Multiply and Sum) for building the medical images are analyzed. From these measurements, a surgical tool’s position tracking system is developed and experimentally assessed in an emulated surgical scenario. The reported results are coherent with other approaches found in the literature, while overcoming their main practical limitations. The discussion of the results discloses some hints on the validity of the system, the optimal configurations depending on the requirements, and the possibilities for future enhancements.

Does robot-assisted navigation influence pedicle screw selection and accuracy in minimally invasive spine surgery?

The accuracy of percutaneous pedicle screw placement has increased with the advent of robotic and surgical navigation technologies. However, the effect of robotic intraoperative screw size and trajectory templating remains unclear. The purpose of this study was to compare pedicle screw sizes and accuracy of placement using robotic navigation (RN) versus skin-based intraoperative navigation (ION) alone in minimally invasive lumbar fusion procedures. A retrospective cohort study was conducted using a single-institution registry of spine procedures performed over a 4-year period. Patients who underwent 1- or 2-level primary or revision minimally invasive surgery (MIS)-transforaminal lumbar interbody fusion (TLIF) with pedicle screw placement, via either robotic assistance or surgical navigation alone, were included. Demographic, surgical, and radiographic data were collected. Pedicle screw type, quantity, length, diameter, and the presence of endplate breach or facet joint violation were assessed. Statistical analysis using the Student t-test and chi-square test was performed to evaluate the differences in pedicle screw sizes and the accuracy of placement between both groups. Overall, 222 patients were included, of whom 92 underwent RN and 130 underwent ION MIS-TLIF. A total of 403 and 534 pedicle screws were placed with RN and ION, respectively. The mean screw diameters were 7.25 ± 0.81 mm and 6.72 ± 0.49 mm (p < 0.001) for the RN and ION groups, respectively. The mean screw length was 48.4 ± 4.48 mm in the RN group and 45.6 ± 3.46 mm in the ION group (p < 0.001). The rates of "ideal" pedicle screws in the RN and ION groups were comparable at 88.5% and 88.4% (p = 0.969), respectively. The overall screw placement was also similar. The RN cohort had 63.7% screws rated as good and 31.4% as acceptable, while 66.1% of ION-placed screws had good placement and 28.7% had acceptable placement (p = 0.661 and p = 0.595, respectively). There was a significant reduction in high-grade breaches in the RN group (0%, n = 0) compared with the ION group (1.2%, n = 17, p = 0.05). The results of this study suggest that robotic assistance allows for placement of screws with greater screw diameter and length compared with surgical navigation alone, although with similarly high accuracy. These findings have implied that robotic platforms may allow for safe placement of the "optimal screw," maximizing construct stability and, thus, the ability to obtain a successful fusion.

Deep learning driven colorectal lesion detection in gastrointestinal endoscopic and pathological imaging.

Colorectal cancer has the second highest incidence of malignant tumors and is the fourth leading cause of cancer deaths in China. Early diagnosis and treatment of colorectal cancer will lead to an improvement in the 5-year survival rate, which will reduce medical costs. The current diagnostic methods for early colorectal cancer include excreta, blood, endoscopy, and computer-aided endoscopy. In this paper, research on image analysis and prediction of colorectal cancer lesions based on deep learning is reviewed with the goal of providing a reference for the early diagnosis of colorectal cancer lesions by combining computer technology, 3D modeling, 5G remote technology, endoscopic robot technology, and surgical navigation technology. The findings will supplement the research and provide insights to improve the cure rate and reduce the mortality of colorectal cancer.

How Does Tibial Pin Placement in Navigated Total Knee Arthroplasty Affect the Torsional Strength of the Tibia?

Surgical navigation technology has recently become more prevalent for total knee arthroplasty. Surgical navigation typically requires pin placement in the proximal tibia diaphysis to stabilize the bone-tracking hardware, and there have been several recent reports of fractures through these residual navigation pin holes. The objective of this biomechanical study was to determine whether a difference exists in the torsional bone strength of a 5-mm navigation pin hole drilled at a single location in three different orientations: unicortical, bicortical, and transcortical. Biomechanical composite sawbone tibias were used to test four conditions: the intact condition with no holes, a unicortical hole, a bicortical hole, and a transcortical hole through the proximal diaphysis. Seven specimens from each group were tested in external rotation to failure at 1 deg/sec. Torque-to-failure, absorbed energy-to-failure, and rotational angle-to-failure were statistically compared across the four groups. All specimens failed proximally by spiral oblique fractures. No statistical differences were found between unicortical and bicortical groups in torque-to-failure, energy-to-failure, and angle-to-failure. However, both unicortical and bicortical groups were markedly lower in all measures than the intact group. The transcortical group was markedly lower in all measures than the intact group and both unicortical and bicortical groups. An appropriately placed navigation residual pin hole, either unicortical or bicortical, markedly decreases the torque-to-failure, energy-to-failure, and angle-to-failure of the tibia compared with the intact condition in a synthetic sawbones model. No notable difference was detected between the unicortical and bicortical holes; however, an errant transcortical residual navigation pin hole markedly decreases all measures compared with an appropriately placed unicortical or bicortical hole.

What are the optimal targeting visualizations for performing surgical navigation of iliosacral screws? A user study.

Complex orthopaedic procedures, such as iliosacral screw (ISS) fixations, can take advantage of surgical navigation technology to achieve accurate results. Although the impact of surgical navigation on outcomes has been studied, no studies to date have quantified how the design of the targeting display used for navigation affects ISS targeting performance. However, it is known in other contexts that how task information is displayed can have significant effects on both accuracy and time required to perform motor tasks, and that this can be different among users with different experience levels. This study aimed to investigate which visualization techniques helped experienced surgeons and inexperienced users most efficiently and accurately align a surgical tool to a target axis. We recruited 21 participants and conducted a user study to investigate five proposed 2D visualizations (bullseye, rotated bullseye, target-fixed, tool-fixed in translation, and tool-fixed in translation and rotation) with varying representations of the ISS targets and tool, and one 3D visualization. We measured the targeting accuracy achieved by each participant, as well as the time required to perform the task using each of the visualizations. We found that all 2D visualizations had equivalent translational and rotational errors, with mean translational errors below 0.9mm and rotational errors below 1.1[Formula: see text]. The 3D visualization had statistically greater mean translational and rotational errors (4.29mm and 5.47[Formula: see text], p < 0.001) across all users. We also found that the 2D bullseye view allowed users to complete the simulated task most efficiently (mean 30.2s; 95% CI 26.4-35.7s), even when combined with other visualizations. Our results show that 2D bullseye views helped both experienced orthopaedic trauma surgeons and inexperienced users target iliosacral screws accurately and efficiently. These findings could inform the design of visualizations for use in a surgical navigation system for screw insertions for both training and surgical practice.

Simulation of preoperative flexion contracture in a computational model of total knee arthroplasty: Development and evaluation

Preoperative flexion contracture is a risk factor for patient dissatisfaction following primary total knee arthroplasty (TKA). Previous studies utilizing surgical navigation technology and cadaveric models attempted to identify operative techniques to correct knees with flexion contracture and minimize undesirable outcomes such as knee instability. However, no consensus has emerged on a surgical strategy to treat this clinical condition. Therefore, the purpose of this study was to develop and evaluate a computational model of TKA with flexion contracture that can be used to devise surgical strategies that restore knee extension and to understand factors that cause negative outcomes. We developed six computational models of knees implanted with a posteriorly stabilized TKA using a measured resection technique. We incorporated tensions in the collateral ligaments representative of those achieved in TKA using reference data from a cadaveric experiment and determined tensions in the posterior capsule elements in knees with flexion contracture by simulating a passive extension exam. Subject-specific extension moments were calculated and used to evaluate the amount of knee extension that would be restored after incrementally resecting the distal femur. Model predictions of the extension angle after resecting the distal femur by 2 and 4 mm were within 1.2° (p ≥ 0.32) and 1.6° (p ≥ 0.25), respectively, of previous studies. Accordingly, the presented computational method could be a credible surrogate to study the mechanical impact of flexion contracture in TKA and to evaluate its surgical treatment.

Virtual Reality Technology and 3D Reconstruction in Hepatectomy

Three dimensional (3D) reconstruction can realize the accurate preoperative diagnosis of liver and intrahepatic tumors, and can also help to complete the preoperative operation planning. 3D visual surgical navigation technology has been applied in liver surgery. Virtual reality (VR) technology is still in the primary stage of research and development. It can only simulate the operation of 3D reconstruction model of liver, but cannot fully show the actual operation scene. With the development of computer technology and the further maturity of 3D reconstruction and VR technology, their application in liver surgery is showing a bright future

Deep learning-driven catheter tracking from bi-plane X-ray fluoroscopy of 3D printed heart phantoms

Minimally invasive surgery (MIS) has changed not only the performance of specific operations but also the more effective strategic approach to all surgeries. Expansion of MIS to more complex surgeries demands further development of new technologies, including robotic surgical systems, navigation, guidance, visualizations, dexterity enhancement, and 3D printing technology. In the cardiovascular domain, 3D printed modeling can play a crucial role in providing improved visualization of the anatomical details and guide precision operations as well as functional evaluation of various congenital and congestive heart conditions. In this work, we propose a novel deep learning-driven tracking method for providing quantitative 3D tracking of mock cardiac interventions on custom-designed 3D printed heart phantoms. In this study, the position of the tip of a catheter is tracked from bi-plane fluoroscopic images. The continuous positioning of the catheter relative to the 3D printed model was co-registered in a single coordinate system using external fiducial markers embedded into the model. Our proposed method has the potential to provide quantitative analysis for training exercises of percutaneous procedures guided by bi-plane fluoroscopy.

Imaging-based navigation technologies in head and neck surgery.

Image guided navigation has had significant impact in head and neck surgery, and has been most prolific in endonasal surgeries. Although conventional image guidance involves static computed tomography (CT) images attained in the preoperative setting, the continual evolution of surgical navigation technologies is fast expanding to incorporate both real-time data and bioinformation that allows for improved precision in surgical guidance. With the rapid advances in technologies, this article allows for a timely review of the current and developing techniques in surgical navigation for head and neck surgery. Current advances for cross-sectional-based image-guided surgery include fusion of CT with other imaging modalities (e.g., magnetic resonance imaging and positron emission tomography) as well as the uptake in intraoperative real-time 'on the table' imaging (e.g., cone-beam CT). These advances, together with the integration of virtual/augmented reality, enable potential enhancements in surgical navigation. In addition to the advances in radiological imaging, the development of optical modalities such as fluorescence and spectroscopy techniques further allows the assimilation of biological data to improve navigation particularly for head and neck surgery. The steady development of radiological and optical imaging techniques shows great promise in changing the paradigm of head and neck surgery.

Virtual Reality Technology and 3D Reconstruction in Hepatectomy

Three-dimensional (3D) reconstruction can realize the accurate preoperative diagnosis of liver and intrahepatic tumors and can also help to complete the preoperative operation planning. 3D visual surgical navigation technology has been applied in liver surgery. Virtual reality (VR) technology is still in the primary stage of research and development. It can only simulate the operation of 3D reconstruction model of liver but cannot fully show the actual operation scene. With the development of computer technology and the further maturity of 3D reconstruction and VR technology, their application in liver surgery is showing a bright future.

Process analysis and application summary of surgical navigation system

In recent years, with the rapid development of computer image processing technology, medical image technology and location tracking technology, computer-aided navigation system helps doctors to determine the best surgical path through preoperative diagnosis, operation path planning, registration and intraoperative navigation, which makes the operation more accurate, rapid and safe, and opens up a new field for the development of surgery. In this paper, the key technologies, process analysis, function realization and clinical application progress of surgical navigation system are briefly summarized. Finally, this paper also makes a prospect for the development trend of surgical navigation technology.

A novel surgical navigation technology for placement of implants in slipped capital femoral epiphysis.

Fixation with a single screw is the recommended treatment for slipped capital femoral epiphysis (SCFE). Achieving optimal implant positioning can be difficult owing to the complex geometry of the proximal femur in SCFE. We assessed a novel navigation technology incorporating an inertial measurement unit to facilitate implant placement in an SCFE model. Guidewires were placed into 30 SCFE models, using a navigation system that displayed the surgeon's projected implant trajectory simultaneously in multiple planes. The accuracy and the precision of the system were assessed as was the time to perform the procedure. Implants were placed an average of 5.3 mm from the femoral head center, with a system precision of 0.94 mm. The actual trajectory of the implant deviated from the planned trajectory by an average of 4.9° ± 2.2°. The total average procedure time was 97 seconds. The use of computer-based navigation in a SCFE model demonstrated good accuracy and precision in terms of both implant trajectory and placement in the center of the femoral head.

Application of augmented-reality surgical navigation technology combined with ICG molecular fluorescence imaging in laparoscopic hepatectomy

Objective: To study the application value of augmented-reality (AR) surgical navigation technology combined with indocyanine green (ICG) molecular fluorescence imaging in three-dimensional (3D) laparoscopic hepatectomy. Methods: The clinical data of forty-eight patients who had undergone 3D laparoscopic hepatectomy for hepatocellular carcinoma at First Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University from January 2018 to April 2019 were retrospectively analyzed.The patients were divided into two groups: the group of 3D laparoscopic hepatectomy navigated by augment reality technology combined with ICG molecular fluorescence imaging (Group A) , and group of conventional 3D laparoscopic hepatectomy (Group B) . Patients in Group A (n=23) underwent 3D laparoscopic hepatectomy using augmented-reality technology combined with ICG molecular fluorescence imaging. In this group, the self-developed three-dimensional laparoscopic augmented-reality surgical navigation system (No. 2018SR840555) was operated to project the preoperative three-dimensional model to the surgical field, and the use of this system in combination with ICG molecular fluorescence imaging navigated laparoscopic hepatectomy. No surgical navigation technology was applied in Group B (n=25) . All patients signed the informed consent, which were in accordance with the requirements of medical ethics (Ethics No.: 2018-GDYK-003) . The preoperative data, surgical indicators and postoperative complications between the two groups were compared and analyzed. Results: The median amount of intraoperative blood loss of Group A was 250 (200) ml (M (Q(R)) ) , which was significantly lower than that of Group B (300 (150) ml) (Z=-2.307, P=0.021) .The transfusion rate of Group A was 13.0% (3/23) , which was significantly lower than that of Group B (40.0%, 10/25) (χ(2)=4.408, P=0.036) .The median postoperative hospitalization time of Group A was 8 (2) d, which was significantly shorter than that of Group B (11 (6.5) d) (Z=-2.694, P=0.007) . There were no serious complications and perioperative death in both groups.The incidence of postoperative complications in Group A was 17.4% (4/23) , which was not significantly different from that in group B (28%, 7/25) (χ(2)=0.763, P=0.382) . Conclusion: Augmented-reality surgical navigation technology combined with ICG molecular fluorescence imaging has better effect in 3D laparoscopic hepatectomy.