Abstract
BACKGROUND: Membrane anatomy (MA) has become pivotal in modern surgery, enabling surgeons to operate within avascular natural planes to minimize concomitant injury. However, intraoperative identification of membranous structures remains challenging. Poor membrane visualization compromises both radical resection and functional preservation, underscoring the need for innovative solutions. METHODS: In this study, we develop a innovative tool, DeepGuide, to help surgeon make membrane visualization during surgery. Moreover, we design a single-arm prospective study to validated its effectiveness. A total of 60 patients undergoing laparoscopic radical resection for gastrointestinal tumors at The Third Affiliated Hospital of Sun Yat-sen University were enrolled. Primary outcomes included signal-to-background ratio (SBR), mesenteric integrity, absorbance of membrane specimens, and immunofluorescence staining of collagen components. RESULTS: DeepGuide significantly improved mesenteric integrity rates from 75% (conventional laparoscopy) to 98%. SBR under DeepGuide (2.30 ± 0.15) surpassed conventional lighting (1.32 ± 0.16). Absorbance analysis revealed reduced light absorption at 385 nm. Immunofluorescence confirmed collagen I/III enrichment in mesenteric submucosa, aligning with 385 nm-excited autofluorescence properties. CONCLUSION: DeepGuide revolutionizes intraoperative membrane visualization without requiring contrast agents. It enhances surgical precision and supports MA principles. These findings highlight DeepGuide's potential to redefine standards in oncologic surgery.