Tumours beneath the surface of the liver can be difficult to locate during laparoscopic, or keyhole, surgery. The new technology uses augmented reality to overlay a 3D visualisation of the tumour and other anatomical structures on the surgeon’s camera view. The visualisation is updated as the camera changes position.
“We have brought together the geometric tools needed to show where the tumour would be visible if the liver were semi-transparent,” says Torbjörn Lundh, Professor at the Department of Mathematical Sciences at Chalmers University of Technology and the University of Gothenburg.
“You can think of it as a GPS inside the organ. Instead of just having a map before surgery, we get continuous guidance based on the current camera angle,” says Niclas Kvarnström, transplant surgeon and Head of the Transplant Centre at Sahlgrenska University Hospital, and a researcher at Sahlgrenska Academy at the University of Gothenburg.
In June 2026, the technology was used in surgery on a patient for the first time.
“The system could be used as planned during the operation, and the workflow worked well. The patient was able to go home the following day,” says Niclas Kvarnström.
A small marker points the way to the tumour
To use the technology, the surgeon places a special sticker on the surface of the liver. The sticker is approximately one square centimetre in size and has a QR code. As long as the camera can see the marker, the system can show the tumour or other structures beneath the surface.
“The sticker acts as an artificial landmark on the surface of the liver, which is otherwise as smooth and even as a polished floor. Put very simply, the marker, together with the camera’s position and the X-ray image taken before surgery, helps us calculate where the tumour should appear. That information can then easily be overlaid on the camera view,” says Torbjörn Lundh.
Aiming to extend the technology to surgery on other organs
Further liver operations are planned for autumn 2026. In parallel, work continues on clinical validation, product development, quality management systems and the steps required to obtain regulatory approval.
In the longer term, a larger international study is planned in collaboration with the Intervention Centre at Oslo University Hospital and hospitals in Washington.
Although the first clinical application has been in liver surgery, the researchers also see potential in other areas.
“Our next major step is to make the method more widely applicable to other laparoscopic procedures. This is a new project that we have just started together with Chalmers Next Labs,” says Torbjörn Lundh.
“This technology can be used in many routine procedures, for tumours in other organs or to keep track of a particular anatomical structure. We are starting with liver surgery, but in the longer term the technology could have much broader applications,” says Niclas Kvarnström.
Research that responds to healthcare needs
The collaboration behind the technology began ten years ago, when surgeons Niclas Kvarnström and Mårten Falkenberg contacted mathematicians Torbjörn Lundh and Klas Modin.
“This is an excellent example of research rooted in a real need in the operating theatre. Together with our master’s thesis students, Klas and I have used and developed the mathematics needed to see where the tumour is hidden,” says Torbjörn Lundh.
He emphasises the importance of collaboration across professional boundaries.
“We hope our collaboration shows that really good things can happen when doctors and mathematicians work together in interdisciplinary teams that focus on the problem rather than the scientific tools, and where team members have a high degree of trust in one another and curiosity about each other’s work,” says Torbjörn Lundh.
More about the project
The work has already resulted in a number of scientific publications and several master’s theses at Chalmers. To develop the technology further into a medical device, the company Navari Surgical was founded with support from Chalmers Ventures. Through the company, the project has also secured funding from Vinnova and several private investors. Region Västra Götaland has provided support with contracts and innovation, among other contributions.
Three master’s theses at Chalmers contributed to the technical development of the project before the company was formed. They were written by Lisa Månsson, Christian Almaleh and Carl Bodin.
Read two of the theses here:
Patents for the tool:
This article is based on a press release from Sahlgrenska University Hospital.
Torbjörn Lundh, Professor at the Department of Mathematical Sciences at Chalmers University of Technology and the University of Gothenburg, both in Sweden, +46 31 772 35 03, torbjorn.lundh@chalmers.se
Niclas Kvarnström, transplant surgeon and Head of the Transplant Centre at Sahlgrenska University Hospital, and a researcher at Sahlgrenska Academy at the University of Gothenburg, both in Sweden. Sahlgrenska University Hospital Press Office: +46 31 342 96 00, press.su@vgregion.se
