Stomach cancer surgery enters the “3D” era

3D technology is no stranger to us, 3D printing, 3D movies … Many have already entered ordinary people’s homes. But have you heard of 3D laparoscopy? When the movie entered the “3D era”, the extra 3D glasses on the bridge of the nose brought a more exciting and cool sensory experience. Similarly, when a surgeon wears a pair of 3D glasses, it also brings revolutionary changes. In recent years, 3D laparoscopy has been increasingly applied to the treatment of digestive tract cancers such as gastric cancer and intestinal cancer.

Because his stomach was uncomfortable, uncle Wang, 75, had not been able to eat or sleep for the past 3 months. At first he thought it was “old stomach disease” and committed it again, so he bought some stomach medicine and ate it, but the results never improved. Recently, Uncle Wang and his family found the director of the Department of Gastrointestinal Surgery, Jingzhou First People’s Hospital, and after gastroscopy + histopathological examination, he was finally diagnosed with gastric antrum adenocarcinoma, and surgery was recommended. Considering that Uncle Wang is older, after weighing the advantages and disadvantages, Xiangjin team designed a surgical method for him: 3D total laparoscopic radical gastric cancer + uncut Roux-en-Y anastomosis.

The surgical team led by the director wore “3D sunglasses”. Under 3D laparoscopic vision, their lymph nodes and blood vessels were more clearly identified than conventional high-definition laparoscopy, making the operation more precise and accurate. The entire operation time was 4.5 hours, and the amount of bleeding About 30 ml. After the operation, Uncle Wang recovered smoothly. He started a liquid diet in a short time and was discharged on the 8th day after the operation.

Uncut Roux-en-Y gastrointestinal anastomosis, unlike traditional roux-en-v anastomosis, does not cut off the jejunum during the operation, preserves the intestinal integrity of the small intestine, ensures the complete transmission of nerve impulses in the small intestine, and greatly reduces retention syndrome In the absence of tumor recurrence and organic intestinal obstruction, chronic upper abdominal pain, bloating, nausea, and vomiting occurred. At the same time, the length of the anastomosis can be adjusted to delay the time for food to pass through the intestine and promote the mixing of food and bile-pancreatic fluid, thereby improving the quality of life and nutritional status of patients after surgery. In addition, because it is performed under a full laparoscope, in addition to its obvious advantages in terms of radicalness, the incision in the umbilicus is relatively small, reducing trauma and increasing aesthetics.

3D laparoscopy to make surgery realistic

3D laparoscopy uses two laparoscopic micro-lenses that enter the patient’s body, each taking an intra-abdominal image, synthesized by a high-performance camera host, and presenting a realistic 3D stereoscopic image on a dedicated monitor, which completely reproduces the real situation inside the human body. The surgeon wears polarized 3D sunglasses and sees the combined stereo image, just like a 3D movie seen in a movie theater.

Conventional 2D laparoscopy can only display plane images, and cannot show the natural depth of objects in the real world. During the operation, doctors need to constantly correct the difference between the plane and reality. In contrast, 3D laparoscopy can be described as an “upgraded version”, which has a higher magnification effect and a stronger three-dimensional sense, especially in the exposure of fine structures. It has obvious advantages and can effectively enhance the perception of depth of surgical operators. Accurate surgical level and judge its relationship with adjacent tissues and organs, clearly reveal and remove the mesangium, make vascular skeletalization and lymph node removal more thorough, especially for experienced experts to perform surgical operations, and it is more accurate at present Surgery provides powerful hardware support for mainstream surgical operations and research directions.

3D surgery makes doctors more handy

The structure of the stomach is complicated, and it is connected to the spleen and liver, and the surrounding large blood vessels are densely packed. Therefore, in laparoscopic radical gastrectomy for gastric cancer, there will be multiple supply vessels, multiple anatomical levels, complicated lymphatic metastasis pathways, and difficult anastomosis techniques, which will increase the intraoperative risk.

Before the advent of 3D, gastric surgery underwent traditional laparotomy and 2D minimally invasive laparoscopic surgery. Traditional open surgery brings huge physiological trauma to the patient. 2D minimally invasive laparoscopic surgery has only two-dimensional images, and cannot directly display stereo effects such as distance and near distance. The operator can only use near and far concepts and related anatomical knowledge. Only indirectly can determine the depth of the organ tissue. For the surgeon, the safety and efficacy of the operation are the indicators that need to be considered most. For the malignant tumor, the curative effect is particularly important. Gastrointestinal malignant tumor surgery often requires large incisions to complete. 3D laparoscopy not only has advantages in the identification of anatomical levels, grasp of vascular lymph node dissection, postoperative organ reconstruction, anastomosis and knotting, etc. The characteristics of small incision are minimally invasive. By changing the way of surgery to enter the abdominal cavity, the patient’s trauma is reduced, the pain is reduced, and the recovery time is greatly shortened.