Intraoperatively available 3D vascular reconstruction navigation in robotic and laparoscopic right hemicolectomy with complete mesocolic excision: a systematic review (2000–2025)

BACKGROUND: Minimally invasive right hemicolectomy (RH) with complete mesocolic excision (CME) is technically demanding due to variable mesenteric vascular anatomy and the need for precise dissection. Intraoperative visualisation tools such as three-dimensional (3D) reconstructions, augmented reality (AR) and mixed reality (MR) are increasingly used to address these challenges. This review evaluates current evidence on their operative performance, safety and oncologic metrics. METHOD: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyse (PRISMA) 2020 guidelines, a PubMed search (updated July 2025) identified English-language studies from 2000 to 2025 reporting intraoperative use of 3D vascular models, AR or MR guidance in robotic or laparoscopic RH. A total of 5 studies comprising 284 RH cases were included: 1 randomised trial, 2 comparative cohorts and 2 feasibility series. Data was extracted on operative time, blood loss, lymph node yield, conversions, complications and user feedback. A narrative synthesis and comparative table summarise the findings. RESULTS: Across the studies, 1-44 RH cases with 3D guidance were reported (total cohorts: 3-112). With 3D assistance, operative time and blood loss were unchanged or reduced: one matched study reported 3 mL versus 10 mL of blood loss (p < 0.001). Lymph node yield was maintained (~28-33 nodes), with one study noting improved central node retrieval. Conversion and complication rates were also unchanged or improved. Surgeons consistently reported enhanced anatomic orientation and procedural confidence. CONCLUSIONS: Intraoperative 3D vascular reconstructions are emerging as feasible and potentially valuable aids in RH with CME. Early evidence suggests improved vascular identification and reduced blood loss without compromising oncologic quality. Further studies are needed to confirm long-term benefits and broader applicability.