Royal Hospital becomes first institution to successfully perform rare rectal cancer surgery

With the introduction of colorectal surgery, the Royal Hospital has become the first institution to successfully perform a laparoscopic ultra-low resection with lateral pelvic lymph node dissection for a low-lying advanced rectal cancer utilising indocyanine green (ICG) and 3D technology.

This innovative surgical technique used by Dr Manar Nassr (pictured), Colorectal Surgeon, marks a significant advancement in the field of rectal cancer treatment.

The Laparoscopic ultra-low resection of rectal cancer with lateral pelvic lymph node dissection using ICG and 3D technology is performed for the first time in the Royal Hospital.

Speaking to the Observer, Dr Manar said the colorectal unit is advancing in a minimally invasive approach for rectal cancer for complete curative resection and to overcome challenges related to the nature of the disease, narrow pelvic space, the proximity of major blood vessels with preservation of microscopic nerve fibres that affect the patients lifestyle after surgery.

"What sets this procedure at the Royal Hospital different is the integration of two cutting-edge technologies, namely, indocyanine green (ICG) and 3D imaging," said Dr Manar.

ICG is a fluorescent dye. When injected into the patient's bloodstream, it selectively accumulates in cancerous and viable tissues. Surgeons use near-infrared light and special cameras to visualise the cancerous tissues and asses vascularisation of the colon highlighted by ICG, enhancing precision and accuracy during resection.

"Furthermore, the implementation of 3D technology provides surgeons with a detailed, three-dimensional view of the surgical site, enhancing their depth perception and spatial awareness. This helps to navigate complex anatomical structures and improve surgical outcomes," Dr Manar added.

Furthermore, the colorectal surgery unit continues to achieve a significant milestones in keyhole surgeries using, where Dr Manar also performed several transanal minimal invasive surgery (TAMIS).

This approach has revolutionised the treatment of rectal growth and specific indication of early-stage cancer, leading to complete and safe resection, reduced pain, shorter hospital stays and faster recovery times.