Strengths and weaknesses analysis, individualized selection and future trends of surgical navigation protocols

Table 1 Single-modality navigation technology and application scenarios

Navigation technology	Core strengths	Main application scenarios	Clinical value
IOUS	Real-time imaging, radiation-free, easy to operate, low cost, and clear visualization of deep structures	Hepatopancreatobiliary surgery	Locate deep-seated lesions; demonstrate the adjacency relationship between lesions and blood vessels/bile ducts; reduce the positive margin rate
ICG-fluorescence imaging	Real-time fluorescence imaging, capable of displaying boundaries/perfusion/Lymph nodes/blood vessels	Hepatobiliary, gastrointestinal, breast and hernia surgery	Tumor boundary visualization; hepatic segment division; anastomotic perfusion assessment; sentinel lymph node biopsy; intraoperative vascular protection
X-ray	Rapid imaging, widespread equipment availability	Biliary surgery, vascular surgery	Cholangiography and stone localization, vascular surgical intervention
Gastrointestinal endoscopy	Direct visualization inside the cavity, localization of minor lesions, and assessment of anastomotic stoma	Gastrointestinal surgery	Mark tumor margins; reduce residual lesions; evaluate anastomosis and guide reinforced suturing; lower the risk of anastomotic leakage
Ultrasound elastography	Assess tissue stiffness	Thyroid surgery, breast surgery	Differentiate benign and malignant nodules; guide the scope of surgical resection

IOUS: Intraoperative ultrasound; ICG: Indocyanine green.