Swedish researchers have developed an interactive 3D technology that allows surgeons to see, during exploratory surgery, where a tumour is located beneath the surface of the liver. Using augmented reality (AR), a three-dimensional representation of the tumour and surrounding anatomical structures is superimposed directly onto the camera image. The visualisation moves in tandem as the surgeon moves the camera. In June 2026, the technology was used on a patient for the first time.
The innovation was developed by researchers at Chalmers University of Technology and the University of Gothenburg, in collaboration with Sahlgrenska University Hospital. The technology is designed to address a well-known problem in laparoscopic liver surgery: tumours located deeper within the organ are not always directly visible during the operation. According to Torbjörn Lundh, a professor at Chalmers and the University of Gothenburg, the system combines various geometric techniques to calculate where a tumour would be visible if the liver were, as it were, transparent.
Navigation for the surgeon
The technology uses images taken before the operation and links them to the live camera feed during the procedure. This means the surgeon receives information about the location of a tumour not only beforehand, but also during the operation. Transplant surgeon Niclas Kvarnström of Sahlgrenska University Hospital compares the system to a GPS within an organ. Whereas a surgeon would normally have a map to hand beforehand, the new technology can provide continuous guidance based on the current position and viewing angle of the laparoscopic camera.
A striking feature of the system is a small sticker, measuring approximately one square centimetre, which is applied to the surface of the liver during the operation. This marker features a QR code. The liver has a relatively smooth surface and therefore offers few landmarks that software can use to determine the camera’s exact position. The sticker thus creates an artificial reference point. As long as the camera can detect the marker, the system combines its position with the camera angle and previously acquired medical imaging.
Based on this, it calculates where the tumour and other anatomical structures are located beneath the surface. This information is then superimposed as an AR image over the live camera feed.
Application in a patient
The technology was first used on a patient during an operation in June. According to Kvarnström, the system could be used as planned during the procedure and fitted well within the surgical workflow. The patient was able to go home the following day. However, this initial application does not yet prove that the technology makes operations safer or, for example, leads to fewer complications or better oncological outcomes. More clinical data is needed for that.
More liver operations using the system are therefore planned for autumn 2026. At the same time, the researchers are working on clinical validation, further product development, quality management and the steps required for approval as a medical device. In the longer term, a larger international study is planned, in collaboration with the Intervention Centre at Oslo University Hospital and hospitals in Washington.
Moreover, the ambitions extend beyond liver surgery. The researchers wish to investigate whether the same technique can be applied to other laparoscopic procedures. This could involve both locating tumours in other organs and visualising important anatomical structures that must be spared during surgery.
3D information on tumours
Last year, we reported on research carried out by the Berlin Institute for Medical Systems Biology at the Max Delbrück Centre. There, scientists developed a method to reconstruct, in three dimensions, not the location of a tumour during surgery, but the complex biological environment of tumour tissue. The researchers combined spatial transcriptomics with imaging of the extracellular matrix. Spatial transcriptomics allows the determination of which genes are active in individual cells, whilst simultaneously preserving the position of those cells within the tissue.
A lung tumour was examined as part of a proof-of-concept study. The scientists analysed approximately 340,000 individual cells and identified eighteen different cell types. Using the computational algorithm STIM, individual datasets were then aligned to reconstruct a virtual 3D tissue block. This enabled the researchers not only to see which cells were present, but also how tumour cells, immune cells and surrounding tissue were spatially organised in relation to one another. Some relevant interactions proved difficult to distinguish clearly in two-dimensional data.
Tumour analysis and navigation
Both developments demonstrate that 3D technology can play various roles within oncology. The German research approach aims to gain an increasingly detailed understanding of a tumour’s biological microenvironment in order to better tailor treatment to the individual tumour. The Swedish innovation, by contrast, uses three-dimensional information to assist the surgeon during an operation.
The interactive AR technology is still in an early clinical phase. It must first be demonstrated that the system functions reliably with larger numbers of patients and actually offers added value for surgical treatment. If this proves successful, the technology could evolve from a digital map viewed prior to an operation into a navigation system that continuously shows, during the procedure, what lies beneath the surface of an organ.
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