Kowal Mikolaj R, Ibrahim Mohammed, Mihaljević André L, Kron Philipp, Lodge Peter
Leeds Institute of Medical Research, University of Leeds, Leeds LS9 7TF, UK.
University Clinic for General, Visceral and Transplantation Surgery, University Hospital Tübingen, 72076 Tübingen, Germany.
J Clin Med. 2025 Jul 30;14(15):5385. doi: 10.3390/jcm14155385.
Surgery remains a healthcare intervention with significant risks for patients. Novel technologies can now enhance the peri-operative workflow, with artificial intelligence (AI) and extended reality (XR) to assist with pre-operative planning. This review focuses on innovation in AI, XR and imaging for hepato-biliary surgery planning. The clinical challenges in hepato-biliary surgery arise from heterogeneity of clinical presentations, the need for multiple imaging modalities and highly variable local anatomy. AI-based models have been developed for risk prediction and multi-disciplinary tumor (MDT) board meetings. The future could involve an on-demand and highly accurate AI-powered decision tool for hepato-biliary surgery, assisting the surgeon to make the most informed decision on the treatment plan, conferring the best possible outcome for individual patients. Advances in AI can also be used to automate image interpretation and 3D modelling, enabling fast and accurate 3D reconstructions of patient anatomy. Surgical navigation systems utilizing XR are already in development, showing an early signal towards improved patient outcomes when used for hepato-biliary surgery. Live visualization of hepato-biliary anatomy in the operating theatre is likely to improve operative safety and performance. The technological advances in AI and XR provide new applications in pre-operative planning with potential for patient benefit. Their use in surgical simulation could accelerate learning curves for surgeons in training. Future research must focus on standardization of AI and XR study reporting, robust databases that are ethically and data protection-compliant, and development of inter-disciplinary tools for various healthcare applications and systems.
手术仍然是一种对患者有重大风险的医疗干预措施。如今,新技术可以通过人工智能(AI)和扩展现实(XR)来辅助术前规划,从而优化围手术期工作流程。本综述聚焦于用于肝胆外科手术规划的人工智能、扩展现实和成像技术的创新。肝胆外科手术面临的临床挑战源于临床表现的异质性、对多种成像方式的需求以及高度可变的局部解剖结构。基于人工智能的模型已被开发用于风险预测和多学科肿瘤(MDT)会诊。未来可能会出现一种按需且高度精确的人工智能驱动的肝胆外科手术决策工具,帮助外科医生就治疗方案做出最明智的决策,为个体患者带来最佳可能的结果。人工智能的进步还可用于自动化图像解读和三维建模,实现患者解剖结构的快速、精确三维重建。利用扩展现实的手术导航系统已在研发中,显示出用于肝胆外科手术时对改善患者预后的早期迹象。在手术室中对肝胆解剖结构进行实时可视化可能会提高手术安全性和操作效果。人工智能和扩展现实的技术进步为术前规划提供了新的应用,有可能使患者受益。它们在手术模拟中的应用可以加快外科住院医师的学习进程。未来的研究必须聚焦于人工智能和扩展现实研究报告的标准化、符合伦理和数据保护要求的强大数据库,以及为各种医疗应用和系统开发跨学科工具。
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