{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T16:03:42Z","timestamp":1793030622660,"version":"4.5.0"},"reference-count":49,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:00:00Z","timestamp":1773964800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Swedish Innovation Fund","award":["108535 IF"],"award-info":[{"award-number":["108535 IF"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.3390\/s26061962","type":"journal-article","created":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T17:02:43Z","timestamp":1774026163000},"page":"1962","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Use of Augmented Reality for Navigation in Minimally Invasive Abdominal and Thoracic Soft-Tissue Surgery: A Systematic Review"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-5120-1117","authenticated-orcid":false,"given":"Inga","family":"Steinberga","sequence":"first","affiliation":[{"name":"Laboratory of Translational Fertility Preservation, Department of Oncology\u2013Pathology, Karolinska Institute, 171 64 Stockholm, Sweden"},{"name":"Department of Gynecology, Division of Gynecology and Reproduction, Karolinska University Hospital, 141 86 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9479-761X","authenticated-orcid":false,"given":"Victor Gabriel","family":"El-Hajj","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience, Karolinska Institute, 171 65 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7818-1356","authenticated-orcid":false,"given":"Laura","family":"Cercenelli","sequence":"additional","affiliation":[{"name":"Laboratory of Bioengineering\u2013eDIMES Lab, Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4616-189X","authenticated-orcid":false,"given":"Mario","family":"Romero","sequence":"additional","affiliation":[{"name":"Department of Science and Technology, Link\u00f6ping University, 601 74 Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4378-6181","authenticated-orcid":false,"given":"Kenny A.","family":"Rodriguez-Wallberg","sequence":"additional","affiliation":[{"name":"Laboratory of Translational Fertility Preservation, Department of Oncology\u2013Pathology, Karolinska Institute, 171 64 Stockholm, Sweden"},{"name":"Department of Reproductive Medicine, Division of Gynecology and Reproduction, Karolinska University Hospital, 141 86 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8781-1169","authenticated-orcid":false,"given":"Erik","family":"Edstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience, Karolinska Institute, 171 65 Stockholm, Sweden"},{"name":"Capio Spine Center, 194 02 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3776-6136","authenticated-orcid":false,"given":"Adrian","family":"Elmi-Terander","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience, Karolinska Institute, 171 65 Stockholm, Sweden"},{"name":"Capio Spine Center, 194 02 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Frisk, H., Jensdottir, M., Coronado, L., Conrad, M., Hager, S., Arvidsson, L., Bartek, J., Burstr\u00f6m, G., El-Hajj, V.G., and Edstr\u00f6m, E. (2024). Automatic image registration provides superior accuracy compared with surface matching in cranial navigation. Sensors, 24.","DOI":"10.21203\/rs.3.rs-4722376\/v1"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.1097\/CORR.0000000000002602","article-title":"Does augmented reality-based portable navigation improve the accuracy of cup placement in THA compared with accelerometer-based portable navigation? A randomized controlled trial","volume":"481","author":"Kurosaka","year":"2023","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Barcali, E., Iadanza, E., Manetti, L., Francia, P., Nardi, C., and Bocchi, L. (2022). Augmented reality in surgery: A scoping review. Appl. Sci., 12.","DOI":"10.3390\/app12146890"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Lai, M., Skyrman, S., Shan, C., Babic, D., Homan, R., Edstr\u00f6m, E., Persson, O., Burstr\u00f6m, G., Elmi-Terander, A., and Hendriks, B.H.W. (2020). Fusion of augmented reality imaging with the endoscopic view for endonasal skull base surgery; a novel application for surgical navigation based on intraoperative cone beam computed tomography and optical tracking. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0229454"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1624","DOI":"10.1016\/j.athoracsur.2020.10.037","article-title":"Augmented reality and 3-dimensional printing technologies for guiding complex thoracoscopic surgery","volume":"112","author":"Li","year":"2021","journal-title":"Ann. Thorac. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1111\/ases.12696","article-title":"Application of image-guided navigation system for laparoscopic hepatobiliary surgery","volume":"13","author":"Yasuda","year":"2020","journal-title":"Asian J. Endosc. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1016\/j.fertnstert.2016.12.016","article-title":"Use of augmented reality in laparoscopic gynecology to visualize myomas","volume":"107","author":"Bourdel","year":"2017","journal-title":"Fertil. Steril."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"9224","DOI":"10.1007\/s00464-022-09409-1","article-title":"Robotically assisted augmented reality system for identification of targeted lymph nodes in laparoscopic gynecological surgery: A first step toward the identification of sentinel node: Augmented reality in gynecological surgery","volume":"36","author":"Lecointre","year":"2022","journal-title":"Surg. Endosc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1873","DOI":"10.1007\/s11701-023-01618-7","article-title":"Visualisation ergonomics and robotic surgery","volume":"17","author":"Wong","year":"2023","journal-title":"J. Robot. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Kawashima, K., Kanno, T., and Tadano, K. (2019). Robots in laparoscopic surgery: Current and future status. BMC Biomed. Eng., 1.","DOI":"10.1186\/s42490-019-0012-1"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1186\/s12957-023-03288-z","article-title":"Clinical evaluation of augmented reality-based 3D navigation system for brachial plexus tumor surgery","volume":"22","author":"Zhao","year":"2024","journal-title":"World J. Surg. Oncol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1109\/TMI.2020.3027442","article-title":"Augmented reality guided laparoscopic surgery of the uterus","volume":"40","author":"Collins","year":"2021","journal-title":"IEEE Trans. Med. Imaging"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2357164","DOI":"10.1080\/24699322.2024.2357164","article-title":"A review on organ deformation modeling approaches for reliable surgical navigation using augmented reality","volume":"29","author":"Han","year":"2024","journal-title":"Comput. Assist. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Lach, A., Kalim, F., Heiliger, C., Piaseczna, N., Grimm, M., Winkler, A., Solyanik, O., Kirr, H., Hiendl, L., and Eck, U. (2022, January 11\u201315). Local Shape Preserving Deformations for Augmented Reality Assisted Laparoscopic Surgery. Proceedings of the 2022 44th Annual International Conference of the IEEE Engineering in Medicine & Biology Society (EMBC), Glasgow, UK.","DOI":"10.1109\/EMBC48229.2022.9871029"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_16","unstructured":"National Institute for Health Research (2025, December 11). International Prospective Register of Systematic Reviews. Available online: https:\/\/www.crd.york.ac.uk\/prospero."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1186\/s13643-016-0384-4","article-title":"Rayyan\u2014A web and mobile app for systematic reviews","volume":"5","author":"Ouzzani","year":"2016","journal-title":"Syst. Rev."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"8682","DOI":"10.1007\/s00464-025-12202-5","article-title":"Real-time image-guided and computer augmented reality in minimally invasive hepatopancreatobiliary surgery cutting edge technology transforming HPB surgery","volume":"39","author":"Gomez","year":"2025","journal-title":"Surg. Endosc."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1749","DOI":"10.1097\/JS9.0000000000002193","article-title":"Efficacy of laparoscopic parenchyma-sparing hepatectomy using augmented reality navigation combined with fluorescence imaging for colorectal liver metastases: A retrospective cohort study using inverse probability treatment weighting analysis","volume":"111","author":"Zeng","year":"2025","journal-title":"Int. J. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"3126","DOI":"10.21037\/tlcr-2025-460","article-title":"Advancements in 3D lung models for minimally invasive lung cancer surgery: From static to real-time dynamic modeling","volume":"14","author":"Laven","year":"2025","journal-title":"Transl. Lung Cancer Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1007\/s11548-024-03308-7","article-title":"A novel 3D image registration technique for augmented reality vision in minimally invasive thoracoscopic pulmonary segmentectomy","volume":"20","author":"Peek","year":"2025","journal-title":"Int. J. Comput. Assist. Radiol. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"15330338241229368","DOI":"10.1177\/15330338241229368","article-title":"Computer Vision and Machine-Learning Techniques for Automatic 3D Virtual Images Overlapping During Augmented Reality Guided Robotic Partial Nephrectomy","volume":"23","author":"Amparore","year":"2024","journal-title":"Technol. Cancer Res. Treat."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Piana, A., Amparore, D., Sica, M., Volpi, G., Checcucci, E., Piramide, F., De Cillis, S., Busacca, G., Scarpelli, G., and Sidoti, F. (2024). Automatic 3D augmented-reality robot-assisted partial nephrectomy using machine learning: Our pioneer experience. Cancers, 16.","DOI":"10.3390\/cancers16051047"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"4702","DOI":"10.1007\/s00464-020-07807-x","article-title":"Comparison of manual and semi-automatic registration in augmented reality image-guided liver surgery: A clinical feasibility study","volume":"34","author":"Schneider","year":"2020","journal-title":"Surg. Endosc."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"S1195","DOI":"10.21037\/jtd.2018.01.32","article-title":"Development of a precision multimodal surgical navigation system for lung robotic segmentectomy","volume":"10","author":"Baste","year":"2018","journal-title":"J. Thorac. Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"4048","DOI":"10.1007\/s00464-024-10922-8","article-title":"Laparoscopic left hemihepatectomy using augmented reality navigation plus ICG fluorescence imaging for hepatolithiasis: A retrospective single-arm cohort study (with video)","volume":"38","author":"Deng","year":"2024","journal-title":"Surg. Endosc."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Bijlstra, O.D., Broersen, A., Oosterveer, T.T.M., Faber, R.A., Achterberg, F.B., Hurks, R., Burgmans, M.C., Dijkstra, J., Mieog, J.S.D., and Vahrmeijer, A.L. (2022). Integration of three-dimensional liver models in a multimodal image-guided robotic liver surgery cockpit. Life, 12.","DOI":"10.3390\/life12050667"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1493","DOI":"10.1007\/s00345-013-1222-0","article-title":"Surgical planning and manual image fusion based on 3D model facilitate laparoscopic partial nephrectomy for intrarenal tumors","volume":"32","author":"Chen","year":"2014","journal-title":"World J. Urol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2251","DOI":"10.1007\/s11605-019-04395-7","article-title":"Efficiency, accuracy and clinical applicability of a new image-guided surgery system in 3D laparoscopic liver surgery","volume":"24","author":"Prevost","year":"2020","journal-title":"J. Gastrointest. Surg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1093\/icvts\/ivw029","article-title":"Small pulmonary nodule localization with cone beam computed tomography during video-assisted thoracic surgery: A feasibility study","volume":"22","author":"Guihaire","year":"2016","journal-title":"Interact. Cardiovasc. Thorac. Surg."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"7373","DOI":"10.1245\/s10434-023-14126-7","article-title":"Augmented reality navigation plus indocyanine green fluorescence imaging can accurately guide laparoscopic anatomical segment 8 resection","volume":"30","author":"Tao","year":"2023","journal-title":"Ann. Surg. Oncol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2221","DOI":"10.1007\/s00345-022-04038-8","article-title":"Uro-technology and SoMe Working Group of the Young Academic Urologists Working Party of the European Association of Urology. The impact of 3D models on positive surgical margins after robot-assisted radical prostatectomy","volume":"40","author":"Checcucci","year":"2022","journal-title":"World J. Urol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1016\/j.urology.2018.01.028","article-title":"Robot-assisted radical prostatectomy with 3D-based augmented reality: Preliminary experience","volume":"115","author":"Porpiglia","year":"2018","journal-title":"Urology"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"346","DOI":"10.21037\/atm-22-5489","article-title":"Computer-assisted intraoperative 3D-navigation for liver surgery: A prospective randomized-controlled pilot study","volume":"11","author":"Huber","year":"2023","journal-title":"Ann. Transl. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"156","DOI":"10.4103\/UROS.UROS_3_18","article-title":"Augmented reality-assisted single-incision laparoscopic adrenalectomy: Comparison with pure single-incision laparoscopic technique","volume":"29","author":"Lin","year":"2018","journal-title":"Urol. Sci."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Zhang, W., Zhu, W., Yang, J., Xiang, N., Zeng, N., Hu, H., Jia, F., and Fang, C. (2021). Augmented reality navigation for stereoscopic laparoscopic anatomical hepatectomy of primary liver cancer: Preliminary experience. Front. Oncol., 11.","DOI":"10.3389\/fonc.2021.663236"},{"key":"ref_37","first-page":"247","article-title":"Virtual simulation, preoperative planning and intraoperative navigation during laparoscopic partial nephrectomy","volume":"72","author":"Dubrovin","year":"2019","journal-title":"Cent. Eur. J. Urol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1097\/XCS.0000000000000912","article-title":"Efficacy of augmented reality combined with indocyanine green fluorescence imaging guided laparoscopic segmentectomy for hepatocellular carcinoma","volume":"238","author":"Wang","year":"2024","journal-title":"J. Am. Coll. Surg."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.1016\/j.euf.2020.08.004","article-title":"Real-time augmented reality three-dimensional guided robotic radical prostatectomy: Preliminary experience and evaluation of the impact on surgical planning","volume":"7","author":"Schiavina","year":"2021","journal-title":"Eur. Urol. Focus"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2598","DOI":"10.1097\/JS9.0000000000000536","article-title":"Augmented reality-assisted navigation system contributes to better intraoperative and short-time outcomes of laparoscopic pancreaticoduodenectomy: A retrospective cohort study","volume":"109","author":"Wu","year":"2023","journal-title":"Int. J. Surg."},{"key":"ref_41","first-page":"9384","article-title":"Use of the AccuVein AV400 during RARP: An infrared augmented reality device to help reduce abdominal wall hematoma","volume":"25","author":"Law","year":"2018","journal-title":"Can. J. Urol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1097\/XCS.0000000000000285","article-title":"Preliminary exploration on the efficacy of augmented reality-guided hepatectomy for hepatolithiasis","volume":"235","author":"Wu","year":"2022","journal-title":"J. Am. Coll. Surg."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"8156","DOI":"10.1007\/s00464-023-10397-z","article-title":"Laparoscopic right hemi-hepatectomy plus total caudate lobectomy for perihilar cholangiocarcinoma via anterior approach with augmented reality navigation: A feasibility study","volume":"37","author":"Wang","year":"2023","journal-title":"Surg. Endosc."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2108","DOI":"10.1007\/s00268-021-06082-8","article-title":"Application of real-time augmented reality laparoscopic navigation in splenectomy for massive splenomegaly","volume":"45","author":"Tao","year":"2021","journal-title":"World J. Surg."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1007\/s11548-015-1293-z","article-title":"Clinical application of a surgical navigation system based on virtual laparoscopy in laparoscopic gastrectomy for gastric cancer","volume":"11","author":"Hayashi","year":"2016","journal-title":"Int. J. Comput. Assist. Radiol. Surg."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1097\/XCS.0000000000000472","article-title":"Perioperative and disease-free survival outcomes after hepatectomy for centrally located hepatocellular carcinoma guided by augmented reality and indocyanine green fluorescence imaging: A single-center experience","volume":"236","author":"Zhu","year":"2023","journal-title":"J. Am. Coll. Surg."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1007\/s11548-015-1346-3","article-title":"Progressive internal landmark registration for surgical navigation in laparoscopic gastrectomy for gastric cancer","volume":"11","author":"Hayashi","year":"2016","journal-title":"Int. J. Comput. Assist. Radiol. Surg."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Viberg, O., Jivet, I., Mu\u00f1oz-Merino, P.J., Perifanou, M., and Papathoma, T. (2023). On Extended Reality Objective Performance Metrics for Neurosurgical Training. Responsive and Sustainable Educational Futures: 18th European Conference on Technology Enhanced Learning (EC-TEL 2023), Springer.","DOI":"10.1007\/978-3-031-42682-7"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"El-Hajj, V.G., Charalampidis, A., Fell, D., Edstr\u00f6m, E., Elmi-Terander, A., and Gerdhem, P. (2025). Study protocol: The SPInal NAVigation (SPINAV) trial\u2014Comparison of augmented reality surgical navigation, conventional image-guided navigation, and free-hand technique for pedicle screw placement in spinal deformity surgery. BMC Musculoskelet. Disord., 26.","DOI":"10.1186\/s12891-025-08817-3"}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/26\/6\/1962\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T17:04:20Z","timestamp":1774026260000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/26\/6\/1962"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,20]]},"references-count":49,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["s26061962"],"URL":"https:\/\/doi.org\/10.3390\/s26061962","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,20]]}}}