Semi-automated vs. manual 3D reconstruction of central mesenteric vascular models: the surgeon’s verdict

Luzon, Javier A; Kumar, Rahul Prasanna; Štimec, Bojan; Elle, Ole Jakob; Bakka, Arne; Edwin, Bjørn; Ignjatović, Dejan

doi:10.1007/s00464-019-07275-y

Cited by 10 publications

(11 citation statements)

References 27 publications

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“…A total of 16 studies (n = 2203 patients) were included [3,7,8,[14][15][16][17][18][19][20][21][22][23][24][25][26]. Most of the studies were performed in Asia (12 studies, 1923 patients) while the rest were from North America (2 studies, 240 patients); Europe (1 study, 13 patients) and the Middle East (1 study, 27 patients).…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Surgical anatomy of the accessory middle colic artery: a meta‐analysis with implications for splenic flexure cancer surgery

et al. 2021

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Splenic flexure cancers (SFCs) account for up to 8% of all colon cancers (CCs) [1,2]. Although relatively uncommon, the prognosis for SFC is generally poor, with patients often presenting with colonic obstruction, advanced tumour stages and distant metastasis [1-3]. Surgical resection of CC has traditionally been undertaken viaan open approach [1]. Laparoscopic resection, however, has gained popularity, with randomized clinical trials demonstrating superior short-term outcomes (lower pain scores, reduced blood loss and shorter convalescence) and similar long-term oncological outcomes to open surgery [4][5][6]. Laparoscopic resection of SFC is technically demanding due to the steep learning curve associated with the procedure and the complex regional anatomy characterized by the presence of embryological adhesions, proximity to important organs such as the spleen and pancreas, and a highly heterogeneous

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Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Surgical anatomy of the accessory middle colic artery: a meta‐analysis with implications for splenic flexure cancer surgery

et al. 2021

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“…Manual segmentation is used in all the 3D reconstructions used in our studies, and it would be tempting to use fully automated or semiautomated segmentation to save the doctor`s time. Some in our group have studied the anatomical completeness of models produced by semi-automatic and manual segmentation (99). They concluded that 3D reconstruction generated from semi-automated segmentation could cause considerable confusion at surgery.…”

Section: D Reconstructionmentioning

confidence: 99%

Defining minimal clearances for adequate lymphatic resection relevant to right colectomy for cancer: a post-mortem study

et al. 2018

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Right colonic lymphovascular bundles are volumes of mesenteric tissue that surround the superior mesenteric vessels anteriorly and posteriorly. Long lymphatic vessels traverse the superior mesenteric vein anteriorly/posteriorly approaching the superior mesenteric artery between arterial bundles and placing the medial clearance on the left side of the artery. These do not correlate to arterial crossing patterns. Cranial-caudal clearances determine the tissue to be removed superior/inferior to arterial origins together with long lymphatic vessels transversing independently between the lymphovascular bundles placing the weight of lymphatic resection on the mesenteric tissue and not on the level of vessel division (High tie).

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“…Further, the 3D virtual model of the SMA-SMV vascular tree underwent detailed morphological and morphometric analyses and was afterwards exported as a three-dimensional volume rendering model (with stills and video clips), as an STL file or a 3D PDF with annotations. The segmentation process and morphometry are already published [10,18] and have been proved to be superior to semiautomatic segmentation [19]. In brief, the detailed report, apart from the description of the ICA/ICV variation, included the following parameters: ICV-GTH (gastrocolic trunk of Henle) length along the SMV right border; vertical aberrance between the origin of the middle colic artery (MCA) and the GTH base; distance between the origins of the colic arteries; MCA length until branching, calibre and course (including accessory MCA, if present); level of origin and calibres of jejunal arteries; inferior mesenteric vein termination pattern; and calibres, crossing pattern and level of termination of jejunal veins (JVs).…”

Section: Methodsmentioning

confidence: 99%

Navigating the mesentery: Part III. Unusual anatomy of ileocolic vessels

Štimec

Ignjatović

2020

Colorectal Disease

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Aim The ileocolic vessels are important landmarks in advanced surgery of the midgut. The aim of the present study is to present variations of ileocolic vessels relevant to complete mesocolic excision with D3 lymphadenectomy of the right colon, within their detailed and precise morphometric framework and deriving from a large and consistent series of operated patients. Methods An ongoing prospective trial 'Safe Radical D3 Right Hemicolectomy for Cancer through Preoperative Biphasic Multidetector Computed Tomography Angiography' was reviewed. The imaging datasets underwent manual segmentation and 3D reconstruction, and the results were validated at surgery. A total of 356 patients were included in the study. Results A cross-section of the series revealed five cases (1.4%) with variation of ileocolic vessels relevant to complete mesocolic excision or D3 extended mesenterectomy. There were two cases with absence of a true classical ileocolic artery, two cases with absence of a true classical ileocolic vein, and one case of precocious bifurcation of the ileocolic artery, left to the superior mesenteric vein. The entire D3 area in all the cases was thoroughly documented and analysed from the morphometric point of view (calibres, lengths of vessels, crossing patterns). Conclusion The preoperative visualization of a patient's individual 3D anatomy is a powerful tool in identifying the variations whose negligence could have dire consequences in complete mesocolic excision of the right colon.

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Semi-automated vs. manual 3D reconstruction of central mesenteric vascular models: the surgeon’s verdict

Cited by 10 publications

References 27 publications

Surgical anatomy of the accessory middle colic artery: a meta‐analysis with implications for splenic flexure cancer surgery

Surgical anatomy of the accessory middle colic artery: a meta‐analysis with implications for splenic flexure cancer surgery

Defining minimal clearances for adequate lymphatic resection relevant to right colectomy for cancer: a post-mortem study

Navigating the mesentery: Part III. Unusual anatomy of ileocolic vessels

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