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Related Experiment Video

Updated: Jul 22, 2025

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Navigation-Assisted Surgery for Locally Advanced Primary and Recurrent Rectal Cancer.

Arne M Solbakken1,2, Simen Sellevold3, Milan Spasojevic4

  • 1Department of Gastroenterological Surgery, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway. arne.solbakken@online.no.

Annals of Surgical Oncology
|July 22, 2023
PubMed
Summary

Navigation-assisted surgery is feasible for rectal cancer, offering accurate intraoperative guidance and acceptable complete resection rates. This technology shows promise for selected patients with advanced or recurrent tumors.

Keywords:
Feasibility studyImage-guided surgeryLocally advanced rectal cancerLocally recurrent rectal cancerNavigation-assisted surgeryOptical tracking

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Area of Science:

  • Surgical Oncology
  • Medical Navigation Technology
  • Rectal Cancer Treatment

Background:

  • Navigation-assisted surgery is standard in some fields, but its role in rectal cancer is unclear.
  • Indications and utility of navigation technologies for rectal cancer require further investigation.

Purpose of the Study:

  • To evaluate the feasibility of navigation-assisted surgery in patients with locally advanced primary rectal cancer (LARC) and locally recurrent rectal cancer (LRRC).
  • To assess the R0 resection rates, surgeon experience, and adherence to preoperative plans in navigation-assisted rectal cancer surgery.

Main Methods:

  • Prospective NAVI-LARRC study (NCT04512937; IDEAL Stage 2a) involving patients with advanced rectal tumors at high risk of incomplete resection.
  • Utilized Brainlab™ navigation platform for preoperative segmentation and intraoperative optical tracking.
  • Classified tumors by pelvic compartmental involvement and assessed R0 resection rates, surgeon experience, and plan adherence.

Main Results:

  • Seventeen patients with posterior/lateral compartment involvement underwent navigation-assisted procedures.
  • Achieved R0 resection in 75% (6/8) of LARC and 69% (6/9) of LRRC cases.
  • Preoperative segmentation was time-consuming (median 3.5h), but intraoperative navigation was accurate; surgeons found it feasible with satisfactory adherence to the plan.

Conclusions:

  • Navigation-assisted surgery with optical tracking is feasible for selected rectal cancer patients.
  • While preoperative planning is lengthy, intraoperative navigation is accurate, yielding acceptable R0 resection rates.
  • This technology may benefit selected patients with advanced or recurrent rectal cancer.