Skip to main content

Advertisement

Log in

Three-dimensional reconstruction of the vascular arrangement including the inferior mesenteric artery and left colic artery in laparoscope-assisted colorectal surgery

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

We performed three-dimensional (3D) reconstruction to investigate the vascular anatomy, including the inferior mesenteric artery (IMA), left colic artery (LCA), and inferior mesenteric vein (IMV), for laparoscope-assisted left-side colorectal surgery. Furthermore, we also examined the distances from the root of the IMA to the bifurcation of the LCA and to the IMV using 3D imaging.

Methods

We retrospectively analyzed 46 patients who underwent laparoscope-assisted left-side colorectal surgery via 3D surgical reconstruction at Tsukuba Medical Center Hospital. The branching patterns among the IMA, LCA, and sigmoidal colic artery (SCA) in colon cancer could be classified into three groups (types A, B, and C): type A, in which both arteries (LCA and SCA) branch off from the same point of the IMA; type B, in which the common trunk of the LCA and SCA branches off from the IMA; and type C, in which the LCA and SCA branch off separately from the IMA. The shortest length from the root of the IMA to bifurcation of the LCA and SCA branches (D mm) or to the IMV (d mm) was measured by 3D imaging.

Results

The mean D mm and d mm for all cases were 39.4 ± 11.2 and 27.9 ± 9.21 mm, respectively. The D mm from the IMA root to the LCA or SCA branch in types A, B, and C was 37.8 ± 9.21, 40.5 ± 12.7, and 38.6 ± 10.2 mm, respectively. Similarly, the d mm from the IMA root to the IMV in types A, B, and C was 30.2 ± 11.3, 29.9 ± 7.27, and 25.2 ± 10.3 mm, respectively.

Conclusion

The present 3D reconstruction technique was useful for determining the 3D vascular anatomical pattern including the relative positions of the IMA, SCA, and IMV during laparoscope-assisted left-side colorectal surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Napolitano AM, Napolitano L, Costantini R, Ucchino S, Innocenti P (1996) Skeletization of the inferior mesenteric artery in colorectal surgery. Current considerations. G Chir 17:185–189

    CAS  PubMed  Google Scholar 

  2. Messinetti S, Giacomelli L, Manno A, Finizio R, Fabrizio G, Granai AV, Busicchio P, Lauria V (1998) Preservation and peeling of the inferior mesenteric artery in the anterior resection for complicated diverticular disease. Ann Ital Chir 69:479–482 (discussion 482–473)

    CAS  PubMed  Google Scholar 

  3. Cirocchi R, Trastulli S, Farinella E, Desiderio J, Vettoretto N, Parisi A, Boselli C, Noya G (2012) High tie versus low tie of the inferior mesenteric artery in colorectal cancer: a RCT is needed. Surg Oncol 21:e111–e123

    Article  PubMed  Google Scholar 

  4. Hida J, Okuno K (2013) High ligation of the inferior mesenteric artery in rectal cancer surgery. Surg Today 43:8–19

    Article  PubMed  Google Scholar 

  5. Mari G, Maggioni D, Costanzi A, Miranda A, Rigamonti L, Crippa J, Magistro C, Di Lernia S, Forgione A, Carnevali P, Nichelatti M, Carzaniga P, Valenti F, Rovagnati M, Berselli M, Cocozza E, Livraghi L, Origi M, Scandroglio I, Roscio F, De Luca A, Ferrari G, Pugliese R (2015) “High or low Inferior Mesenteric Artery ligation in Laparoscopic low Anterior Resection: study protocol for a randomized controlled trial” (HIGHLOW trial). Trials 16:21

    Article  PubMed  PubMed Central  Google Scholar 

  6. Kobayashi M, Okamoto K, Namikawa T, Okabayashi T, Araki K (2006) Laparoscopic lymph node dissection around the inferior mesenteric artery for cancer in the lower sigmoid colon and rectum: is D3 lymph node dissection with preservation of the left colic artery feasible? Surg Endosc 20:563–569

    Article  CAS  PubMed  Google Scholar 

  7. Sekimoto M, Takemasa I, Mizushima T, Ikeda M, Yamamoto H, Doki Y, Mori M (2011) Laparoscopic lymph node dissection around the inferior mesenteric artery with preservation of the left colic artery. Surg Endosc 25:861–866

    Article  PubMed  Google Scholar 

  8. Kobayashi M, Morishita S, Okabayashi T, Miyatake K, Okamoto K, Namikawa T, Ogawa Y, Araki K (2006) Preoperative assessment of vascular anatomy of inferior mesenteric artery by volume-rendered 3D-CT for laparoscopic lymph node dissection with left colic artery preservation in lower sigmoid and rectal cancer. World J Gastroenterol 12:553–555

    Article  PubMed  PubMed Central  Google Scholar 

  9. Chin CC, Yeh CY, Tang R, Changchien CR, Huang WS, Wang JY (2008) The oncologic benefit of high ligation of the inferior mesenteric artery in the surgical treatment of rectal or sigmoid colon cancer. Int J Colorectal Dis 23:783–788

    Article  PubMed  Google Scholar 

  10. Kanemitsu Y, Hirai T, Komori K, Kato T (2006) Survival benefit of high ligation of the inferior mesenteric artery in sigmoid colon or rectal cancer surgery. Br J Surg 93:609–615

    Article  CAS  PubMed  Google Scholar 

  11. Dworkin MJ, Allen-Mersh TG (1996) Effect of inferior mesenteric artery ligation on blood flow in the marginal artery-dependent sigmoid colon. J Am Coll Surg 183:357–360

    CAS  PubMed  Google Scholar 

  12. Seike K, Koda K, Saito N, Oda K, Kosugi C, Shimizu K, Miyazaki M (2007) Laser Doppler assessment of the influence of division at the root of the inferior mesenteric artery on anastomotic blood flow in rectosigmoid cancer surgery. Int J Colorectal Dis 22:689–697

    Article  PubMed  Google Scholar 

  13. Tocchi A, Mazzoni G, Fornasari V, Miccini M, Daddi G, Tagliacozzo S (2001) Preservation of the inferior mesenteric artery in colorectal resection for complicated diverticular disease. Am J Surg 182:162–167

    Article  CAS  PubMed  Google Scholar 

  14. Hino T, Okajima M, Ikeda S, Yoshimitsu M, Ohdan H, Watanabe M (2008) Effect of left colonic artery preservation on anastomotic leakage in laparoscopic anterior resection for middle and low rectal cancer. Abstract book of 2008 ELSA (Endoscopic and Laparoscopic Surgeons of Asia) September 5–6, Yokohama Japan. Abstract number ES27-3, p 33

  15. Kamel IR, Kruskal JB, Pomfret EA, Keogan MT, Warmbrand G, Raptopoulos V (2001) Impact of multidetector CT on donor selection and surgical planning before living adult right lobe liver transplantation. AJR Am J Roentgenol 176:193–200

    Article  CAS  PubMed  Google Scholar 

  16. Miyamoto R, Oshiro Y, Hashimoto S, Kohno K, Fukunaga K, Oda T, Ohkohchi N (2014) Three-dimensional imaging identified the accessory bile duct in a patient with cholangiocarcinoma. World J Gastroenterol 20:11451–11455

    Article  PubMed  PubMed Central  Google Scholar 

  17. Mise Y, Tani K, Aoki T, Sakamoto Y, Hasegawa K, Sugawara Y, Kokudo N (2013) Virtual liver resection: computer-assisted operation planning using a three-dimensional liver representation. J Hepato-Biliary-Pancreatic Sci 20:157–164

    Article  Google Scholar 

  18. Spasojevic M, Stimec BV, Fasel JF, Terraz S, Ignjatovic D (2011) 3D relations between right colon arteries and the superior mesenteric vein: a preliminary study with multidetector computed tomography. Surg Endosc 25:1883–1886

    Article  CAS  PubMed  Google Scholar 

  19. Hirai K, Yoshinari D, Ogawa H, Nakazawa S, Takase Y, Tanaka K, Miyamae Y, Takahashi N, Tsukagoshi H, Toya H, Totsuka O, Sunose Y, Takeyoshi I (2013) Three-dimensional computed tomography for analyzing the vascular anatomy in laparoscopic surgery for right-sided colon cancer. Surg Laparosc Endosc Percutan Tech 23:536–539

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We thank the Department of Radiology, Tsukuba Medical Center Hospital, for consultation on 3D imaging.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ryoichi Miyamoto.

Ethics declarations

Disclosures

Ryoichi Miyamoto, Kentaro Nagai, Akira Kemmochi, Satoshi Inagawa, and Masayoshi Yamamoto have no potential conflicts of interest to disclose.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Miyamoto, R., Nagai, K., Kemmochi, A. et al. Three-dimensional reconstruction of the vascular arrangement including the inferior mesenteric artery and left colic artery in laparoscope-assisted colorectal surgery. Surg Endosc 30, 4400–4404 (2016). https://doi.org/10.1007/s00464-016-4758-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-016-4758-4

Keywords

Navigation