AI+AR Navigation! Jiangsu Provincial People's Hospital Technology Further Expands Precision Treatment Boundaries

Background

Small pulmonary nodules are frequently identified on computed tomography (CT) scans during routine examinations or evaluations for other conditions. When these nodules raise suspicion for early-stage lung cancer, surgical resection is often considered. Traditional localization of small or deeply situated nodules prior to minimally invasive thoracoscopic surgery has typically involved a separate preoperative procedure under CT guidance while the patient is awake. This step can involve patient discomfort, anxiety, radiation exposure, and risks including pneumothorax or bleeding.

What was achieved

In early October 2025, the thoracic surgery team led by Professor Chen Liang at Jiangsu Provincial People's Hospital performed what multiple reports describe as the nation's first procedure combining AI+AR navigation for lung nodule puncture localization with 3D-CTBA-guided fluorescence thoracoscopic pulmonary subsegmentectomy. The patient was a woman in her sixties, referred to in reports as Zhang Ayi, who had a nodule located in the right middle lobe. Dr. Pan Xianglong participated in the localization portion of the case.

The localization was completed in the operating room after anesthesia using AR guidance to place an umbrella-shaped marker adjacent to the nodule. This was followed by a right lung S4a single subsegmentectomy. Reports indicate the approach enabled precise identification and removal of the targeted area while maximizing preservation of surrounding healthy lung tissue. The combined technique was performed successfully according to available news coverage.

How it works

Prior to surgery, the patient's CT imaging data is loaded into a specialized AI system. The software generates a detailed three-dimensional panoramic navigation map that depicts the nodule's size and precise location along with the branching patterns of the bronchi and pulmonary vessels, as well as the positions of ribs and other structures. This creates a comprehensive anatomical blueprint, referred to in reports as a 'digital twin' of the relevant thoracic anatomy.

During the operation, after the patient is under general anesthesia, the surgeon wears AR glasses. These glasses overlay the 3D navigation data onto the real-world view, allowing real-time guidance for needle insertion and deployment of the localization marker along an optimal path that avoids critical structures such as vessels and ribs. Reports note this step was completed efficiently. The marker then assists during the subsequent minimally invasive thoracoscopic phase, where fluorescence imaging, guided by the preoperative 3D-CTBA reconstruction, helps delineate the anatomic boundaries of the specific lung subsegment for precise resection. This approach aims to remove the diseased tissue while conserving as much functional lung as possible.

What it means for international patients

Jiangsu Provincial People's Hospital maintains an office for international cooperation and has experience providing care to patients from other countries, including through structured processes for overseas visitors. The hospital regularly hosts international medical training programs, such as those aligned with the Belt and Road Initiative, which have involved physicians from multiple nations in fields including surgery and endoscopy.

International patients interested in precision thoracic surgery or related technologies at this facility should contact the hospital directly to confirm current availability, individual eligibility based on their specific medical condition, and all logistical and clinical requirements. Suitability for any particular technique, including AI+AR navigation combined with subsegmentectomy, must be determined through professional medical evaluation by the treating team.

About the hospital

Jiangsu Provincial People's Hospital is located in Nanjing, Jiangsu Province, China. Established in 1936, it is a large Grade A tertiary comprehensive public hospital and serves as the First Affiliated Hospital of Nanjing Medical University. It also operates as the Jiangsu Provincial Academy of Clinical Medicine and incorporates the Jiangsu Maternal and Child Health Hospital under integrated management. The facility is one of the largest hospitals in the province and handles medical treatment, teaching, research, and international exchange.

It includes a dedicated Lung Cancer Center within its thoracic surgery department, which has focused on minimally invasive techniques and precision anatomic lung resections using 3D-CTBA planning. The hospital engages in international medical activities, including training programs for foreign physicians and care for patients traveling from abroad. It maintains multiple national and provincial key clinical specialties.