# The Use of Augmented Reality for Navigation in Minimally Invasive Abdominal and Thoracic Soft-Tissue Surgery: A Systematic Review

## TL;DR

Augmented reality shows promise for guiding minimally invasive abdominal and thoracic surgeries, but more large-scale studies are needed to validate its effectiveness.

## Contribution

This systematic review identifies the current state and limitations of AR in soft-tissue surgery, highlighting the need for standardized studies and integration with robotic systems.

## Key findings

- AR improves anatomical guidance and procedural planning in complex surgeries.
- Integration with robotic systems may enhance visualization and precision.
- Research is limited in gynecologic surgery and lacks large-cohort validation.

## Abstract

What are the main findings?
Evidence supporting the use of augmented reality (AR) technology in minimally invasive abdominal and thoracic soft-tissue surgery is mostly limited to small-scale or preliminary studies and lacks comprehensive validation. In gynecologic surgery, current research is scarce and does not provide adequately validated outcomes.Guidance with AR systems requires deformable anatomical tracking and multimodal intraoperative data fusion to ensure safety and effectiveness.

Evidence supporting the use of augmented reality (AR) technology in minimally invasive abdominal and thoracic soft-tissue surgery is mostly limited to small-scale or preliminary studies and lacks comprehensive validation. In gynecologic surgery, current research is scarce and does not provide adequately validated outcomes.

Guidance with AR systems requires deformable anatomical tracking and multimodal intraoperative data fusion to ensure safety and effectiveness.

What are the implications of the main findings?
AR systems offer clinical potential as guidance tools, but adoption is limited by small sample sizes, varied study designs, and non-standardized reporting. Larger, high-quality studies, standardized training, and objective evaluation metrics are needed.Successful AR-assisted surgery relies on real-time, deformable anatomical tracking with multimodal imaging. This enhances alignment, precision, and safety, especially when using robotic platforms.

AR systems offer clinical potential as guidance tools, but adoption is limited by small sample sizes, varied study designs, and non-standardized reporting. Larger, high-quality studies, standardized training, and objective evaluation metrics are needed.

Successful AR-assisted surgery relies on real-time, deformable anatomical tracking with multimodal imaging. This enhances alignment, precision, and safety, especially when using robotic platforms.

Surgical navigation and augmented reality (AR) are widely used in neurosurgery, spinal surgery, and orthopedics. However, their use in minimally invasive abdominal and thoracic soft-tissue surgery is limited, as tracking deformable, mobile organs is challenging. Recent advances in AR may address these challenges to improve intraoperative navigation. This systematic review, registered in PROSPERO (2024) and based on PRISMA guidelines, analyzes literature from 2014 to 2024 about AR in minimally invasive abdominal and thoracic soft-tissue surgery. It identifies target organs, describes AR hardware and software, and evaluates accuracy levels, usability outcomes, clinical benefits, technical limitations, and research needs. Searches of PubMed, Web of Science, and Embase for English-language studies found 1297 records, of which only 28 (2%) met the inclusion criteria. Nearly half (n =12; 42%) focused on liver surgery; none on gynecologic surgery. The AR devices varied in tracking methods, image processing, visualization, and display. Overall, AR improved anatomical guidance and procedural planning, especially in complex surgeries. Integration with robotic systems may further boost visualization, precision, and workflow, though challenges remain in standardization, large-cohort validation, and workflow integration.