Enhancing Sentinel Lymph Node Biopsy in Endometrial Cancer Using Augmented and Mixed Reality

Abstract

Sentinel lymph node biopsy offers a less invasive alternative to full lymphadenectomy in endometrial cancer, reducing complications while maintaining diagnostic accuracy. This case report highlights the integration of holography and augmented reality (AR) in a 34-year-old woman undergoing robotic-assisted surgery for endometrial cancer. Preoperative imaging combined with single-photon emission computed tomography and computed tomography identified sentinel lymph nodes, which were visualized using mixed reality (MR) technology. This approach enabled the surgical team to accurately understand the three-dimensional spatial relationships between lymph nodes and surrounding critical structures. Holographic projections provided precise guidance during surgery, improving lymph node identification and minimizing invasiveness. No lymph node metastasis was detected, but a diagnosis of the International Federation of Gynecology and Obstetrics (FIGO) stage IIIA was confirmed due to tumor seeding in the peritoneum. The patient underwent successful adjuvant chemotherapy with no recurrence observed. This report demonstrates the significant potential of holography and AR to enhance spatial awareness and surgical precision. These technologies represent a promising advancement in sentinel lymph node biopsy for patients with gynecologic cancers, contributing to reduced surgical invasiveness and alleviating stress for surgeons.