In the era of artificial intelligence (AI), the combination of holographic imaging technique with robotic-assisted partial adrenalectomy (RAPA) has been underused. We aimed to report the holographic imaging technique, surgical technique, and perioperative outcomes of a holographic imaging-assisted RAPA series.

Data of 9 consecutive patients who underwent holographic imaging-assisted RAPA for adrenal tumor from February 2023 to August 2024 were retrospectively collected and analyzed. Before surgery, engineers established the holographic image models based on the enhanced CT data. The models were used in patient consultation, surgical planning and surgical procedure simulation. During the procedure, the intraoperative navigation was achieved by real- time overlapping of the holographic images on the robotic surgery endoscopic views. The transperitoneal approach was used in RAPA and the normal adrenal tissue were preserved.

All the cases were completed robotically. Median tumor size was 14 mm (interquartile range (IQR) 8.5-16.5). The median operative time was 80 minutes (IQR 55-112.5), and the median estimated blood loss was 10 ml (IQR 5-20). Pain level on POD 1 was 2 (IQR 0.5-2.5). There were no Clavien-Dindo≥2 perioperative complications. Median hospital stay was 3 days (IQR 2–4.5). At a median follow-up of 5 months (IQR 2-11.5) and no recurrence was found by imaging.

We demonstrated feasibility and safety of the holographic imaging-assisted RAPA. This technique facilitates surgical planning and the surgeon’s communication with patients. The real-time intraoperative holographic imaging navigation helps the surgeon to accurately identify and locate the tumor, and to achieves better outcomes in RAPA. This technique enhanced the safety and success rate of RAPA and makes the wide application of RAPA a treatment option for adrenal tumors