Three-dimensional computed tomography simulation for laparoscopic lymph node dissection in the treatment of proximal gastric cancer

Abstract

Application of laparoscopic surgery (LS) has expanded worldwide in the various fields due to the potential advantage of being less invasive than open surgery; however difficulty in recognizing positional relationship of the organs is one of the disadvantages of this kind of surgery. In order to compensate this drawback, preoperative three-dimensional computed tomography (3D-CT) simulation is regarded as promising. In gastric cancer surgery, 3D-CT simulation seems particularly effective in the splenic hilar dissection, because this region is associated with remarkable anatomical variation with complexity. As effects from the use of 3D-CT simulation, reduction of blood loss or complication rate, shortening of operation time and enhancement of surgical quality are expected. In this article, we introduce our methodological protocol of 3D-CT simulation in gastric cancer surgery with clinical case examples, and also additionally review previous publications reporting this imaging technology.

Significance of prediction of the dorsal landmark using three-dimensional computed tomography during laparoscopic lymph node dissection along the proximal splenic artery in gastric cancer

“…This is because conventional two-dimensional (2D)-CT images cannot be rotated and we could not simulate the organ positional relationship in the actual view, including that of the dorsal landmark of No. 11p LN dissection using 2D-CT. 8,9 Recently, three-dimensional (3D)-CT has been used for preoperative simulation in numerous surgeries. Several studies on gastric surgery have demonstrated the usefulness of prediction for splenic hilum or perigastric vessels.…”

“…Several studies on gastric surgery have demonstrated the usefulness of prediction for splenic hilum or perigastric vessels. [8][9][10] However, there is no study on the prediction of anatomical landmarks during LN dissection in gastric surgery using preoperative 3D-CT. Moreover, it is still unclear whether 3D-CT improves surgical outcomes in laparoscopic gastrectomy with No.…”