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

Abstract

Background: Augmented reality (AR)-assisted navigation system 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 advantages of laparoscopic pancreatoduodenectomy guided by the AR-assisted navigation system in intraoperative and short-time outcomes. Methods: 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 baseline features, operation time, intraoperative blood loss, blood transfusion rate, perioperative complications, and mortality were analyzed. Results: AR-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. Conclusion: AR-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.