A trial to improve keyhole surgery for rectal cancer

Cancer type:

Bowel (colorectal) cancer
Rectal cancer





This trial looked at whether 3 dimensional (3D) images can improve the accuracy of keyhole surgery for rectal cancer. Rectal cancer is cancer of the back passage (rectum).

The trial was open for people to join between 2016 and 2018. The team published the results in 2019.

More about this trial

Doctors often treat rectal cancer with surgery, including keyhole (laparoscopic) surgery. They make small cuts and pass a tube with a camera inside the tummy (abdomen) to remove the area of cancer. 

When this trial was done, surgeons usually used a 2 dimensional (2D) image on a TV screen to help them see, and remove, the area of cancer.

In this trial they were testing if using a screen that shows a 3 dimensional (3D) image was helpful. This had been successfully used in surgery to remove other types of cancer. But it had not been used in surgery for rectal cancer before.

Some people in this trial had surgery using a 2D TV screen and some had surgery using a 3D TV screen.

The main aim of the trial was to see if using 3D imaging gave a better view and improved the accuracy of the surgery for rectal cancer.

Summary of results

The research team found that it was possible to use a 3D image for surgery to remove rectal cancer. There wasn’t much difference between using a 2D image and a 3D image.

Trial design
This trial was for people who were due to have surgery for rectal cancer. The surgeons used either a 2D or 3D image to help them see the area of cancer.

The research team looked at how well the surgery went for people in both groups.

A total of 88 people joined this trial. They were put into 1 of 2 groups at random. There were:

  • 43 people in the group who had surgery using a 2D image
  • 45 people in the group who had surgery using a 3D image


The research team looked at a number of different factors both during and after the operation. They wanted to see if there was any difference between the 2 groups for the patient or the surgeon.

They found there was no difference during the operation for things such as:

  • how difficult the surgeons found the operation
  • how long the operation took
  • how many people needed to have open surgery (where the surgeon makes a bigger cut in the abdomen to remove the cancer) 
  • bleeding and other side effects during the operation

And there was no difference after the operation, for things such as:

  • the side effects people had up to a month after surgery
  • how long people were in hospital
  • the number of people who had to go back into hospital
  • the number of people who needed a second operation

The surgeons were able to completely remove the sheet of tissue that surrounds the rectum (the mesorectum) in a few more people in the 3D image group. But the difference between the groups was not big enough to say for sure that it was because the of different imaging. It may have been due to chance.

The research team concluded that it was possible to do rectal surgery using a 3D TV screen. But that there was little difference in the outcome compared to using a 2D TV screen.

The suggest that more work is done looking at whether using a 3D image makes it easier to remove the mesorectum.

Where this information comes from    
We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item) and published in a medical journal. The figures we quote above were provided by the trial team who did the research. We have not analysed the data ourselves.

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

 Professor Nader K Francis

Supported by

European Association of Endoscopic Surgeons
Karl Storz UK
Yeovil District Hospital NHS Foundation Trust

If you have questions about the trial please contact our cancer information nurses

Freephone 0808 800 4040

Last review date

CRUK internal database number:


Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Last reviewed:

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