Can 3D visualisation and navigation techniques improve pancreatic surgery? A systematic review

Pancreatic cancer, namely pancreatic ductal adenocarcinoma (PDAC), is an intractable cancer with a 5-year survival of around 7%-10%. Surgery with adjuvant chemotherapy remains the mainstay of curative treatment. The pancreas is a retroperitoneal organ that lies close to major arterial and venous structures, and it is the involvement of these structures that currently technically limits surgical resection with curative intent for pancreatic cancer. It is possible to resect venous and arterial structures involved in cancer to expand options for patients for whom surgery was previously deemed infeasible, but this is best performed in high-volume pancreatic surgery centres. Here, we explore the role that 3D visualisation and navigation surgery have in improving preoperative planning and operative execution, the role they may play in training and education and in enabling the development of novel surgical techniques in pancreatic surgery.