Application value of mixed reality in hepatectomy for hepatocellular carcinoma.

Background: As a new digital holographic imaging technology, mixed reality (MR) technology has unique advantages in determining the liver anatomy and location of tumor lesions. With the popularization of 5G communication technology, MR shows great potential in preoperative planning and intraoperative navigation, making hepatectomy more accurate and safer.

Aim: To evaluate the application value of MR technology in hepatectomy for hepatocellular carcinoma (HCC).

Methods: The clinical data of 95 patients who underwent open hepatectomy surgery for HCC between June 2018 and October 2020 at our hospital were analyzed retrospectively. We selected 95 patients with HCC according to the inclusion criteria and exclusion criteria. In 38 patients, hepatectomy was assisted by MR (Group A), and an additional 57 patients underwent traditional hepatectomy without MR (Group B). The perioperative outcomes of the two groups were collected and compared to evaluate the application value of MR in hepatectomy for patients with HCC.

Results: We summarized the technical process of MR-assisted hepatectomy in the treatment of HCC. Compared to traditional hepatectomy in Group B, MR-assisted hepatectomy in Group A yielded a shorter operation time (202.86 ± 46.02 min 229.52 ± 57.13 min, = 0.003), less volume of bleeding (329.29 ± 97.31 mL 398.23 ± 159.61 mL, = 0.028), and shorter obstructive time of the portal vein (17.71 ± 4.16 min 21.58 ± 5.24 min, = 0.019). Group A had lower alanine aminotransferas and higher albumin values on the third day after the operation (119.74 ± 29.08 U/L 135.53 ± 36.68 U/L, = 0.029 and 33.60 ± 3.21 g/L 31.80 ± 3.51 g/L, = 0.014, respectively). The total postoperative complications and hospitalization days in Group A were significantly less than those in Group B [14 (37.84%) 35 (60.34%), = 0.032 and 12.05 ± 4.04 d 13.78 ± 4.13 d, = 0.049, respectively].

Conclusion: MR has some application value in three-dimensional visualization of the liver, surgical planning, and intraoperative navigation during hepatectomy, and it significantly improves the perioperative outcomes of hepatectomy for HCC.