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Updated: Jan 6, 2026
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Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
6.3K
Tailored-Surgery for Locally Advanced Rectal Cancer Based on 3D Mathematical Reconstruction Surgical Planner:
Álvaro García-Granero1,2,3, Sebastián Jeri-McFarlane1,2, Gianluca Pellino4,5
1From the Colorectal Unit, General and Digestive Surgery Department, Hospital Universitario Son Espases, Palma de Mallorca, Spain.
Summary
A new 3D image processing and reconstruction system using pelvic MRI is feasible for planning rectal cancer surgery. This advanced 3D-IPR tool enhances surgical planning and decision-making for complex cases.
Area of Science:
- Medical Imaging
- Surgical Planning
- Oncology
Background:
- Achieving R0 resection is crucial for locally advanced rectal cancer (LARC) and pelvic recurrence rectal cancer (PRCR) prognosis.
- Two-dimensional (2D) imaging presents limitations in visualizing complex pelvic anatomy for precise surgical planning.
- Three-dimensional (3D) reconstruction offers potential for improved visualization and surgical decision-making.
Purpose of the Study:
- To assess the feasibility of a 3D image processing and reconstruction (3D-IPR) system utilizing pelvic MRI for surgical planning in LARC and PRCR.
- To evaluate the impact of 3D-IPR on surgical approach and outcomes for rectal cancer patients.
Main Methods:
- A prospective, multicenter feasibility study involving 37 patients with LARC or PRCR and threatened circumferential resection margins on MRI.
- Surgical planning was performed using the 3D-IPR system, which provided detailed tumor localization, infiltration volume, and spatial relationships with adjacent structures.
- Outcomes measured included surgeon satisfaction, modifications to surgical approach, and perioperative results.
Main Results:
- The 3D-IPR system achieved 100% surgeon satisfaction for selecting the optimal surgical route.
- In 37.8% of cases, 3D-IPR influenced decisions regarding surgical approach to adjacent organs.
- R0 resection was achieved in 75.7% of patients, with no perioperative mortality and a 27% severe complication rate.
Conclusions:
- A 3D surgical planner based on pelvic MRI reconstruction is feasible for tailored surgery in LARC and pelvic recurrence.
- Further research is needed to determine if 3D-IPR can reduce morbidity and mortality, increase R0 resection rates, and improve survival.
