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Related Experiment Video

Updated: Jan 30, 2026

Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
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2D versus 3D laparoscopic total mesorectal excision: a developmental multicentre randomised controlled trial.

N J Curtis1,2, J A Conti3,4, R Dalton5

  • 1Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, Level 10, Praed Street, London, UK. nathancurtis@doctors.org.uk.

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|January 19, 2019
PubMed
Summary

Three-dimensional (3D) laparoscopy did not significantly change adverse events during rectal cancer surgery. However, 3D imaging showed a potential improvement in mesorectal specimen quality for total mesorectal excision (TME).

Keywords:
3DLaparoscopicRectal cancerThree-dimensionalTotal mesorectal excisionTrial

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Area of Science:

  • Minimally Invasive Surgery
  • Surgical Oncology
  • Medical Imaging Technology

Background:

  • The efficacy of laparoscopy in rectal cancer surgery is debated.
  • Three-dimensional (3D) laparoscopic systems may enhance surgical performance but lack evaluation in complex procedures like total mesorectal excision (TME).

Purpose of the Study:

  • To investigate whether stereoscopic (3D) imaging improves surgical performance in laparoscopic TME for rectal cancer.
  • To assess the feasibility of conducting multicenter 3D laparoscopic trials for complex surgical procedures.

Main Methods:

  • A multicenter randomized controlled trial compared 2D and 3D laparoscopic TME in experienced colorectal surgeons.
  • Outcomes included adverse events, intraoperative data, patient outcomes, specimen assessment, and surgeon cognitive load.

Main Results:

  • No significant differences were observed in patient demographics, operative time, blood loss, or conversion rates between 2D and 3D groups.
  • Intraoperative adverse events were similar (18 per case). 3D laparoscopy showed a trend towards improved mesorectal fascial plane resection (94% vs. 77%) but not statistical significance.
  • Lymph node yield and margin status were comparable; 30-day morbidity and outcomes were equal between groups.

Conclusions:

  • Multicenter 3D laparoscopic trials for complex procedures are feasible.
  • While 3D imaging did not reduce intraoperative adverse events, it suggested potential benefits in mesorectal specimen quality, warranting further investigation.