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Application of 3D-reconstruction and artificial intelligence for complete mesocolic excision and D3 lymphadenectomy
Alvaro Garcia-Granero1, Sebastían Jerí Mc-Farlane2, Margarita Gamundí Cuesta2
1Unidad de Coloproctología, Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Son Espases, Palma, Illes Balears, Spain; Instituto de Investigación Sanitaria Illes Balears (IdISBa), Palma, Illes Balears, Spain; Unidad de Reconstrucción-3D y Centro de Simulación, Hospital Universitario Son Espases, Palma, Illes Balears, Spain; Profesor Departamento de Anatomía y Embriología Humana, Universidad de Islas Baleares, Palma, Illes Balears, Spain; Coordinador Unidad de Anatomía Quirúrgica Aplicada, Universidad de Valencia, Valencia, Spain.
Abstract:
Mathematical algorithms 3D-reconstruction techniques and artificial intelligence are a current line of innovation in colorectal surgical oncology. The objective of this study is to show the initial experience of a 3D image processing and reconstruction system to perform complete mesocolic excision and D3-lymphadenectomy in colon cancer. It is applied to a splenic flexure neoplasm and in a right colon cancer with suspected retroperitoneal infiltration. 3D image processing and reconstruction was employed to delimit 10 cm proximal and distal intestinal margins to the tumor and define its corresponding vascularization. In right colon cancer it showed position and exact dimensions of D3-lymphadenectomy area and possible retroperitoneal fascia infiltration. 3D image processing and reconstruction allows to obtain valuable information from computerized tomography scan. It could be employed during surgical strategy planification to improve oncological results and reduce intraoperative complications.
