Abstract:
The mesenteric vessels of the right colon have complex classifications and high variation rates. Restricted by planar field of view, traditional two-dimensional laparoscopy has inherent shortcomings in preoperative vascular prediction, intraoperative fine dissection, complete central lymph node dissection and quantitative perioperative risk assessment. The digital intelligent technology system centered on AI 3D reconstruction, 3D printed physical models, fluorescent laparoscopy, surgical robots, MR real-time superimposed navigation and deep learning intraoperative recognition can reduce core surgical risks such as vascular laceration, massive hemorrhage and incomplete lymph node cleaning from the whole process of preoperative planning, intraoperative operation and postoperative quality control, and significantly improve the standardization of D3 radical resection. Based on comprehensive intelligent imaging evaluation of tumor T stage, Henle trunk classification and patients' underlying comorbidities, a three-level individualized surgical stratification scheme can match adapted minimally invasive equipment, dissection scope and digestive tract reconstruction methods for low, medium and high-risk populations to realize differentiated precise surgical treatment. Compared with traditional Logistic regression models, machine learning models constructed based on random forest and SVM algorithms have significantly higher discrimination and predictive efficiency for anastomotic leakage, surgical site infection and long-term tumor recurrence. The deep integration of digital intelligent diagnosis and treatment platform and individualized stratified surgical model has reshaped the traditional minimally invasive diagnosis and treatment paradigm of right colon cancer, which can simultaneously improve the radicality of tumor resection, intraoperative safety and patients' long-term quality of life. However, there are obvious gaps in the intraoperative real-time occlusion removal recognition algorithm of AI and long-term multicenter oncological endpoint evidence of domestic surgical robots at this stage. Larger-scale, longer follow-up prospective randomized controlled studies are needed to further verify its clinical promotion value.
Key words:
Right Colon Cancer,
Complete Mesocolic Excision,
Minimally Invasive Surgery,
Artificial Intelligence,
Mixed Reality,
Individualized Stratified Therapy
Su Yan, Kunshan He, Hongyu Xie, Bowen Huo, Yunrong Liu, Yuanyuan Li. Intelligentization and individualization in minimally invasive surgery for right-sided colon cancer[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2026, 20(05): 414-419.