Prospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Aug 27, 2025; 17(8): 109069
Published online Aug 27, 2025. doi: 10.4240/wjgs.v17.i8.109069
Navigating anatomical complexity in laparoscopic sigmoid cancer surgery: A three-dimension reconstruction protocol for intraoperative safety and efficiency
Zong-Xian Zhao, Run-Dong Yao, Zong-Ju Hu, Chao-Qian Chen, Shu Zhu, Yuan Yao
Zong-Xian Zhao, Run-Dong Yao, Zong-Ju Hu, Chao-Qian Chen, Shu Zhu, Yuan Yao, Department of Anorectal Surgery, Fuyang People’s Hospital, Fuyang 236000, Anhui Province, China
Author contributions: Zhao ZX and Yao Y designed the research study and completed the manuscript; Yao RD, Hu ZJ, Chen CQ and Zhu S performed the research.
Supported by the Health Commission of Fuyang City, Anhui, China, No. FY2023-45; Fuyang Municipal Science and Technology Bureau, Anhui, China, No. FK20245505; Anhui Provincial Health Commission, No. AHWJ2023Baa20164; and Bengbu Medical University, No. 2023byzd215.
Institutional review board statement: This study was approved by the Ethics Committee of Fuyang City People's Hospital.
Clinical trial registration statement: This study was registered at the Chinese Clinical Trial Registry (ChiCTR) under the registration number ChiCTR2400274904 on November 14, 2022.
Informed consent statement: Consent for publication was given in writing by the patient’s relatives.
Conflict-of-interest statement: The authors declare that they have no competing interests.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: The data are available from the corresponding author upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yuan Yao, Department of Anorectal Surgery, Fuyang People’s Hospital, No. 501 Sanqing Road, Yingzhou District, Fuyang 236000, Anhui Province, China. lining787878@126.com
Received: April 30, 2025
Revised: June 2, 2025
Accepted: June 18, 2025
Published online: August 27, 2025
Processing time: 118 Days and 11.7 Hours
Abstract
BACKGROUND

Sigmoid colon cancer faces challenges due to anatomical diversity, including variable inferior mesenteric artery (IMA) branching and tumor localization complexities, which increase intraoperative risks.

AIM

To comprehensively evaluate the impact of three-dimensional (3D) visualization technology on enhancing surgical precision and safety, as well as optimizing perioperative outcomes in laparoscopic sigmoid cancer resection.

METHODS

A prospective cohort of 106 patients (January 2023 to December 2024) undergoing laparoscopic sigmoid cancer resection was divided into the 3D (n = 55) group and the control (n = 51) group. The 3D group underwent preoperative enhanced computed tomography reconstruction (3D Slicer 5.2.2 & Mimics 19.0). 3D reconstruction visualization navigation intraoperatively guided the following key steps: Tumor location, Toldt’s space dissection, IMA ligation level selection, regional lymph node dissection, and marginal artery preservation. Outcomes included operative parameters, lymph node yield, and recovery metrics.

RESULTS

The 3D group demonstrated a significantly shorter operative time (172.91 ± 20.69 minutes vs 190.29 ± 32.29 minutes; P = 0.002), reduced blood loss (31.5 ± 11.8 mL vs 44.1 ± 23.4 mL, P = 0.001), earlier postoperative flatus (2.23 ± 0.54 days vs 2.53 ± 0.61 days; P = 0.013), shorter hospital length of stay (13.47 ± 1.74 days vs 16.20 ± 7.71 days; P = 0.013), shorter postoperative length of stay (8.6 ± 2.6 days vs 10.5 ± 4.9 days; P = 0.014), and earlier postoperative exhaust time (2.23 ± 0.54 days vs 2.53 ± 0.61 days; P = 0.013). Furthermore, the 3D group exhibited a higher mean number of lymph nodes harvested (16.91 ± 5.74 vs 14.45 ± 5.66; P = 0.030).

CONCLUSION

The 3D visualization technology effectively addresses sigmoid colon anatomical complexity through surgical navigation, improving procedural safety and efficiency.

Keywords: Three-dimension reconstruction; Sigmoid colon cancer; Visualization; Inferior mesenteric artery; Anatomical complexity; Intraoperative safety

Core Tip: This prospective study evaluated the role of three-dimensional (3D) reconstruction technology in laparoscopic sigmoid colon cancer surgery. Preoperative 3D models generated via contrast-enhanced computed tomography and 3D Slicer/Mimics software guided tumor localization, vascular assessment, and lymph node dissection. Compared with the control group, the 3D group showed shorter operative time, less blood loss, earlier postoperative recovery, and higher lymph node yield, demonstrating that 3D visualization enhances surgical precision and safety in managing anatomical complexities of laparoscopic sigmoid colon cancer.