B-APP is an innovative software that integrates Digital Twin technology, Augmented Reality (AR), and Artificial Intelligence (AI) to support the planning, simulation, and optimization of endoscopic bariatric surgery, with a specific focus on Endoscopic Sleeve Gastroplasty (ESG).
Starting from pre-operative MRI imaging, the system reconstructs a three-dimensional, patient-specific model of the stomach using AI algorithms for the automatic segmentation and recognition of soft tissues from biomedical images. This virtual anatomical model enables the surgeon to define suture patterns, visualize the post-surgical gastric morphology, and simulate food intake by modeling internal pressure variations and the biomechanical deformation of the gastric wall under realistic conditions.
The Digital Twin framework couples experimentally validated biomechanical models of human gastric tissue with physiological simulations, providing quantitative feedback on gastric capacity, wall stress distribution, and mechanoreceptor activation involved in satiety perception. This approach enables predictive evaluation of surgical efficacy, supporting pre-operative decision-making and reducing intra- and post-operative risks.
B-APP also will incorporate an immersive Augmented Reality environment, where surgeons can use a head-mounted AR visor and handheld controllers replicating the movements and tactile feedback of surgical instruments. This setup allows for realistic interaction with the virtual model, including the manipulation of sutures, incision placement, and assessment of tissue response, thereby enhancing spatial perception, depth awareness, and manual precision.
Designed as a modular, scalable, and CE-certifiable platform, B-APP serves both as a clinical decision-sup.port tool and as a training simulator for surgical education. By combining scientific rigor with immersive technology, B-APP paves the way for a new generation of predictive, patient-specific digital surgery, improving safety, precision, and personalization in bariatric care.