Digital and intelligent liver surgery in the new era: Prospects and dilemmas

Despite tremendous advances in traditional imaging technology over the past few decades, the intraoperative identification of lesions is still based on naked eye observation or pre-operative image evaluation. However, these two-dimensional image data cannot objectively reflect the complex anatomical structure of the liver and the detailed morphological features of the lesion, which directly limits the clinical application value of these imaging data in surgery in that it cannot improve the curative efficacy of surgery and the prognosis of the patient. This traditional mode of diagnosis and treatment has been changed by digital medical imaging technology in the new era with its significant function of accurate and efficient diagnosis of diseases, selection of reasonable treatment schemes, improvement of radical resection rate and reduction of surgical risk. In this paper, we reviewed the latest application of digital intelligent diagnosis and treatment technology related to liver surgery in the hope that it may help to achieve accurate treatment of liver surgery diseases. Keywords: Digital medicine, Liver surgery, 3D visualization, 3D printing, Virtual realit

Current applications of artificial intelligence-based computer vision in laparoscopic surgery

Recent advances in artificial intelligence (AI) have sparked a surge in the application of computer vision (CV) in surgical video analysis. Laparoscopic surgery produces a large number of surgical videos, which provides a new opportunity for improving of CV technology in laparoscopic surgery. AI-based CV techniques may leverage these surgical video data to develop real-time automated decision support tools and surgeon training systems, which shows a new direction in dealing with the shortcomings of laparoscopic surgery. The effectiveness of CV applications in surgical procedures is still under early evaluation, so it is necessary to discuss challenges and obstacles. The review introduced the commonly used deep learning algorithms in CV and described their usage in detail in four application scenes, including phase recognition, anatomy detection, instrument detection and action recognition in laparoscopic surgery. The currently described applications of CV in laparoscopic surgery are limited. Most of the current research focuses on the identification of workflow and anatomical structure, while the identification of instruments and surgical actions is still awaiting further breakthroughs. Future research on the use of CV in laparoscopic surgery should focus on applications in more scenarios, such as surgeon skill assessment and the development of more efficient models

2-Methoxyestradiol loaded mesoporous polydopamine nanoprobes for hypoxia alleviation and sorafenib synergistic treatment of hepatocellular carcinoma

Hepatocellular carcinoma is a common and highly malignant disease. As a currently designated systemic chemotherapeutic agent for advanced Hepatocellular carcinoma, sorafenib has been confronted with dilemma of drug-resistance caused by tumor hypoxia, which hinders the therapeutic efficacy of the drug. Based on this, a multifunctional mesoporous polydopamine nanoprobe 2Me-SPIO-CY5.5@AAZ-MPDA with a mesoporous frame loaded 2-Methoxyestradiol, Superparamagnetic Iron Oxide Nanoparticles and the near-infrared dye cyanine 5.5, conjugated with hypoxia Hepatocellular carcinoma-specific targeting molecule of sulfonamides acetazolamide, is fabricated for hypoxic region targeting, sorafenib resistance reversion and photothermal therapy of Hepatocellular carcinoma. In addition, the magnetic resonance imaging/fluorescence/photoacoustic tri-modal imaging ability enables the tracing of the nanoprobes and monitoring the treatment procedure in vivo, providing a new methods of imaging-guided Hepatocellular carcinoma synergic treatment which improves the long-term therapeutic effects of sorafenib

Review and Application of Integrin Alpha v Beta 6 in the Diagnosis and Treatment of Cholangiocarcinoma and Pancreatic Ductal Adenocarcinoma

Integrin Alpha v Beta 6 is expressed primarily in solid epithelial tumors, such as cholangiocarcinoma, pancreatic cancer, and colorectal cancer. It has been considered a potential and promising molecular marker for the early diagnosis and treatment of cancer. Cholangiocarcinoma and pancreatic ductal adenocarcinoma share genetic, histological, and pathophysiological similarities due to the shared embryonic origin of the bile duct and pancreas. These cancers share numerous clinicopathological characteristics, including growth pattern, poor response to conventional radiotherapy and chemotherapy, and poor prognosis. This review focuses on the role of integrin Alpha v Beta 6 in cancer progression. It addition, it reviews how the marker can be used in molecular imaging and therapeutic targets. We propose further research explorations and questions that need to be addressed. We conclude that integrin Alpha v Beta 6 may serve as a potential biomarker for cancer disease progression and prognosis

From Detection to Resection: Photoacoustic Tomography and Surgery Guidance with Indocyanine Green Loaded Gold Nanorod@liposome Core–Shell Nanoparticles in Liver Cancer

Conventional imaging methods encounter challenges in diagnosing liver cancer that is less than 10 mm or without typical hypervascular features. With deep penetration and high spatial resolution imaging capability, the emerging photoacoustic tomography may offer better diagnostic efficacy for noninvasive liver cancer detection. Moreover, near-infrared fluorescence imaging-guided hepatectomy was proven to be able to identify nodules at the millimeter level. Thus, suitable photoacoustic and fluorescence dual-modality imaging probe may benefit patients in early diagnosis and complete resection. In this study, we fabricated indocyanine green loaded gold nanorod@liposome core–shell nanoparticles (Au@liposome–ICG) to integrate both imaging strategies. These nanoparticles exhibit superior biocompatibility, high stability, and enhanced dual-model imaging signals. Next, we explored their effectiveness of tumor detection and surgery guidance in orthotopic liver cancer mouse models. Histological analysis confirmed the accuracy of the probe in liver cancer detection and resection. This novel dual-modality nanoprobe holds promise for early diagnosis and better surgical outcome of liver cancer and has great potential for clinical translation

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SLN needle aspiration biopsy process based on the guidance of real-time photoacoustic imagin