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Published on: December 15, 2023
Tumour Localisation Technologies in Colorectal Cancer Surgery: A Scoping Review of Marking and Detection Methods
Mircea Fulea1, Mihaela Mocan2, Mircea Murar1
1Design Engineering and Robotics Department, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania.
Diagnostics (Basel, Switzerland)
|July 15, 2026
Summary
Accurate localization of small colorectal tumors during laparoscopic surgery is difficult. Indocyanine green (ICG) fluorescence shows promise, while radiofrequency identification (RFID) systems require further colorectal validation and comparative trials.
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery
- Medical Technology Assessment
Background:
- Intraoperative localization of small colorectal tumors during laparoscopic surgery is challenging due to lack of tactile feedback and subserosal location.
- Current methods like India ink tattooing have high failure rates (15-30%) for small lesions (<10 mm), leading to complications.
- Fragmented evidence exists for emerging localization technologies, hindering comparative analysis.
Purpose of the Study:
- To map and characterize intraoperative marking and identification technologies for small colorectal tumor localization in laparoscopic surgery.
- To emphasize radiofrequency-based methods and alternatives, identifying evidence gaps for future research.
- To provide a comprehensive overview of current localization technologies and their clinical applicability.
Main Methods:
- Systematic literature search (PubMed, Web of Science, Scopus) from 2000-2025 following PRISMA-ScR guidelines.
- Inclusion of studies on colorectal cancer surgery, liver metastases localization, and transferable GI applications.
- Data extraction on technical performance, safety, feasibility, cost-effectiveness, usability, innovation, and evidence quality by two independent reviewers.
Main Results:
- 89 studies included: 18 colorectal-specific, 71 transferable/GI-adjacent; detection rates 71-100%.
- Near-infrared fluorescence with indocyanine green (ICG) shows strong evidence (75-100% detection) in 8 colorectal studies.
- Radiofrequency identification (RFID) systems show high detection (91.9-99%) but limited colorectal validation; electromagnetic navigation struggles with mobile bowel (71-75%).
Conclusions:
- ICG fluorescence is the most clinically mature technology for colorectal tumor localization, requiring further validation.
- RFID systems show promise and warrant research investment via comparative trials.
- Future research should focus on comparative effectiveness studies, standardized metrics, and integration with robotic/AI platforms.
