Three-dimensional printing for preoperative rehearsal and intraoperative navigation during laparoscopic rectal cancer surgery with left colic artery preservation

World J Gastrointest Surg. 2024 Oct 27;16(10):3104-3113. doi: 10.4240/wjgs.v16.i10.3104.

Abstract

Background: Prior studies have shown that preserving the left colic artery (LCA) during laparoscopic radical resection for rectal cancer (RC) can reduce the occurrence of anastomotic leakage (AL), without compromising oncological outcomes. However, anatomical variations in the branches of the inferior mesenteric artery (IMA) and LCA present significant surgical challenges. In this study, we present our novel three dimensional (3D) printed IMA model designed to facilitate preoperative rehearsal and intraoperative navigation to analyze its impact on surgical safety.

Aim: To investigate the effect of 3D IMA models on preserving the LCA during RC surgery.

Methods: We retrospectively collected clinical dates from patients with RC who underwent laparoscopic radical resection from January 2022 to May 2024 at Fuyang People's Hospital. Patients were divided into the 3D printing and control groups for statistical analysis of perioperative characteristics.

Results: The 3D printing observation group comprised of 72 patients, while the control group comprised 68 patients. The operation time (174.5 ± 38.2 minutes vs 198.5 ± 49.6 minutes, P = 0.002), intraoperative blood loss (43.9 ± 31.3 mL vs 58.2 ± 30.8 mL, P = 0.005), duration of hospitalization (13.1 ± 3.1 days vs 15.9 ± 5.6 days, P < 0.001), postoperative recovery time (8.6 ± 2.6 days vs 10.5 ± 4.9 days, P = 0.007), and the postoperative complication rate (P < 0.05) were all significantly lower in the observation group.

Conclusion: Utilization of a 3D-printed IMA model in laparoscopic radical resection of RC can assist surgeons in understanding the LCA anatomy preoperatively, thereby reducing intraoperative bleeding and shortening operating time, demonstrating better clinical application potential.

Keywords: Inferior mesenteric artery; Intraoperative navigation; Left colic artery; Preoperative rehearsal; Rectal cancer; Three-dimensional printing.