Abstract:

The clinical application of 3D laparoscopy is the product of the combination of industry and medicine, which has changed the surgeon’s understanding of the original anatomical structure, and made the sub-microstructure that once could not be recognized present in reality and three-dimensional. The sense of three-dimensional space of 3D laparoscopy can help surgeons to find the correct anatomical layers and fascial space easily. 3D laparoscopic right hemicolectomy for colorectal cancer, In the process of CME, the longitudinal depth of 3D laparoscopic field of vision and the true presentation of sub-microstructure were used to expand the posterior space of ascending colon and the posterior space of transverse colon along the fascial space between the right Toldt fascia and urogenital fascia, so as to identify the anterior pancreaticoduodenal fascia, Treitz fascia and Fredet fascia, and to ensure the integrity of the visceral mesocolon and the dorsal urogenital fascia, and also to realize the right colon and its mesentery are removed in en bloc finally. In addition, 3D laparoscopy presents a three-dimensional space, which can clearly reveal the surgical trunk, and perform three-dimensional dissection of the lymph nodes at the root of the blood vessels to achieve D3 lymphadenectomy. The optimal CME + D3 radical operation can improve 5-year survival rate and reduce local recurrence rate of patients with advanced right colon cancer. Good exposure of operative field and correct identification of fascial layer are the key to achieve CME + D3 radical resection of right colon cancer, while 3D laparoscopy plays the role of " director" in CME + D3 radical resection of right colon cancer, and guides the chief surgeon as No.1 player into the holy plane, which ensures the safety and quality of CME + D3 operation.

Key words: Colorectal neoplasms, Laparoscopy, CME, Right colon cancer