Hepato-Pancreato-Biliary (HPB) Surgery

L-SURGAR

Augmented Reality for Hepatectomy

Over 800,000 people are diagnosed with liver cancer worldwilde each year1. While partial hepatectomy is the most common treatment, its complexity, due to the liver’s dense vascular structure, often leads surgeons to choose open surgery over minimally invasive techniques (MIS).

SURGAR is developing L-SURGAR™, an augmented reality device that enhances intraoperative visualization of critical liver structures.

By addressing the key challenges of liver MIS, L-SURGAR™ empowers surgeons to operate with greater precision and safety, helping to expand the adoption of MIS and improve outcomes for liver cancer patients.

Discover the Research Case

A 58-year-old patient was scheduled at Saint-Étienne University Hospital for a double hepatic resection targeting two hepatocellular carcinomas (HCC) located in Segments V and VII of a cirrhotic liver. The first lesion was successfully resected. However, the second lesion, measuring 11 mm, proved more challenging to locate, as it was not detectable via laparoscopic ultrasound due to the presence of macro-nodular cirrhosis.

Such tumors present significant technical challenges: limited intraoperative visibility increases the risk of conversion to open surgery, positive resection margins (R1), and potential vascular or biliary injury.

The use of SURGAR technology enabled precise intraoperative localization of the second lesion. Consequently, laparoscopic resection was completed successfully. Histopathological examination confirmed complete (R0) resection of both lesions, with clear surgical margins.

"In this complex case, the L‑SURGAR system enabled the surgical team to preserve a minimally invasive approach while ensuring precise resection margins and upholding patient safety."

- Pr. Bertrand Le Roy, Digestive Surgeon, Saint-Étienne University Hospital

Disclaimer: L-SURGAR™ is an investigational technology. It is not yet approved for commercial use. Any opinions expressed are those of the investigators and reflect research experience only.

Urologic Surgery

K-SURGAR

Augmented Reality for Partial Nephrectomy

Kidney cancer affects over 400,000 people worldwide each year, with robotic partial nephrectomy being the preferred treatment. However, the procedure remains technically challenging due to the kidney’s complex anatomy, often resulting in extended operative time, ischemia, and blood loss. 

K-SURGAR™, currently in development, is a robotic-by-design augmented reality solution that enhances intraoperative visualization of critical kidney structures in real-time.

By improving surgical precision and efficiency, SURGAR aims to reduce operative, and enable surgical centers to expand their programs, delivering more minimally invasive, kidney-sparing procedures to patients. 

Discover the Research Case

A 58-year-old male, enrolled in the Digital Urology 3D Program, underwent robot-laparoscopic partial nephrectomy for a hilar, endophytic renal tumor, located deep within the renal parenchyma, adjacent to the main renal artery and vein. The tumor was not visible on the kidney surface pre-resection, posing high risk for conversion to open surgery, positive margins, and complications.

 

K-SURGAR Application:

Using augmented reality guidance, the surgical team visualized the 3D reconstructed tumor margins, vascular pedicle, and collecting system anatomy directly overlaid onto the laparoscopic field. The device facilitated:

  • Precise localization of the invisible tumor
  • Safer dissection around the renal hilum
  • Optimized time through resection
  • Confidence in tumor margin control despite endophytic growth pattern

 

Preliminary Outcomes (research use only):

  • No conversion to open surgery
  • Negative surgical margins confirmed on pathology
  • Complication-free recovery (Clavien–Dindo 0–I)
  • Operative time aligned with institutional benchmarks despite case complexity

“For complex hilar and endophytic tumors, K-SURGAR brings real confidence. It helps localize hidden lesions, reduces the risk of conversion and positive margins, and fits naturally into the robot-laparoscopic workflow.”

- Dr. Jean-Christophe Bernhard, Urologic Surgeon, University Hospital of Bordeaux

Disclaimer: K-SURGAR™ is an investigational technology, involved in the Digital Urology 3D program. It is not yet approved for commercial use.

Any opinions expressed are those of the investigators and reflect research experience only.

Use of SURGAR Media Kit

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