To evaluate the application value of mixed reality (MR) technology in the navigation of laparoscopic hepatectomy.

Clinical data of 60 patients with liver lesions who underwent laparoscopic hepatectomy in the First People's Hospital of Yunnan Province from September, 2019 to January, 2022 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 27 patients were male and 33 female, aged from 25 to 72 years, with a median age of 50 years. All patients were divided into the MR group (n=30) and non-MR group (NMR group, n=30) according to whether MR technology was employed. In the MR group, laparoscopic hepatectomy was performed under the guidance of Kunhua Weile MR-based surgical navigation system, and conventional two-dimensional imaging was used for preoperative planning in the NMR group. Perioperative conditions and postoperative recurrence were observed in two groups. The data between two groups, such as operation time and intraoperative blood loss, were compared by Mann-Whitney U test. The incidence of postoperative complications and recurrence rates were compared by Chi-square test.

In the MR group, the median operation time and intraoperative blood loss were 170(123) min and 125(268) ml,significantly less than 300(183) min and 250(550) ml in the NMR group (Z=-4.182, -2.287; P<0.05). Postoperative blood transfusion rate in the MR group was 17%(5/30), significantly lower than 37%(11/30) in the NMR group (χ²=5.079, P<0.05). In the MR group, the length of postoperative hospital stay was 8(6) d,significantly shorter compared with 11(5) d in the NMR group (Z=-3.120, P<0.05). The incidence rates of postoperative complications in the MR and NMR groups were 37%(11/30) and 53%(16/30), and no significant difference was observed (χ²=1.684, P>0.05). All patients were followed up for 3-24 months, with a median of 9 months. During the follow-up, 6 cases recurred in the MR group and 9 in the NMR group, and no significant difference was observed (χ²=0.800, P>0.05).

For patients undergoing laparoscopic hepatectomy, intraoperative MR technology can realize accurate preoperative evaluation and real-time intraoperative navigation. Application of MR technology can significantly shorten the operation time, reduce intraoperative blood loss and lower blood transfusion rate, thus helps to improve the surgical precision, safety and feasibility.