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Related Experiment Video

Updated: May 17, 2025

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[Laparoscopic Proximal Sigmoid Colon Cancer Surgery Using Surgical-Assisted CT Colonography].

Kazuo Narushima1, Toru Tonooka, Hiroaki Soda

  • 1Dept. of Esophageal-Gastrointestinal Surgery Chiba Cancer Center.

Gan to Kagaku Ryoho. Cancer & Chemotherapy
|April 7, 2025
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Summary

Surgical-assisted CT colonography (CTC) aids laparoscopic surgery for proximal sigmoid colon cancer by enabling precise vascular and mesenteric planning. This advanced imaging technique facilitated a safe and effective procedure with no postoperative complications.

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Area of Science:

  • Surgical Oncology
  • Medical Imaging
  • Gastroenterology

Background:

  • Preoperative understanding of vascular anatomy is crucial for safe laparoscopic surgery of proximal sigmoid colon cancer.
  • Preserving the distal sigmoid colon and managing the mesentery require detailed vascular insights.

Purpose of the Study:

  • To report the utility of surgical-assisted CT colonography (CTC) in a case of laparoscopic proximal sigmoid colon cancer surgery.
  • To demonstrate the creation and application of a combined CTC and 3D-CT vascular model for surgical navigation.

Main Methods:

  • A patient with proximal sigmoid colon cancer underwent contrast-enhanced CTC preoperatively.
  • 3D-CT images (arterial and venous) were integrated with CTC data using SYNAPSE VINCENT software to create a surgical-assisted CTC model.
  • The model was used for preoperative simulation of D3 lymph node dissection and enterotomy/mesenterotomy planning.

Main Results:

  • Surgical-assisted CTC provided navigation for planned D3 lymph node dissection, focusing on specific sigmoid colon arteries and veins.
  • The surgery was performed successfully using the CTC model as a guide, with a total operative time of 197 minutes and 30g blood loss.
  • The patient experienced no postoperative complications, was discharged on day 8, and showed no recurrence at 9 months.

Conclusions:

  • Sophisticated surgical-assisted CTC is a valuable tool for laparoscopic proximal sigmoid colon cancer surgery.
  • This technique enhances preoperative planning and intraoperative navigation, contributing to successful surgical outcomes.