Saving the Anus in Ultra-Low Rectal Cancer: 16 Years of Refined Conformal ISR Technique

Our hospital's Gastrointestinal Surgery Department (a provincial key specialty) was established as an independent division from the General Oncology Surgery Department in early 2008, focusing exclusively on standardized diagnosis and treatment of gastric and colorectal cancers, with particular emphasis on sphincter-preserving surgery for ultra-low rectal cancer. On June 18, 2011, we independently performed laparoscopic D2 radical gastrectomy, D3 radical resection for colorectal cancer, and sphincter-preserving surgery for ultra-low rectal cancer (including conformal resection ISR and NOSES procedures). By early 2012, these sphincter-preserving techniques had matured and were widely applied clinically. In 2015, this technological innovation received certification from Wuwei Municipal Science and Technology Bureau, followed by winning the First Prize (7th edition) and Third Prize (9th edition) at the Gansu Provincial Workers' Excellent Technological Innovation Achievements Competition in 2016.

In June 2023, we successfully performed 680 cases of sphincter-preserving surgery for ultra-low rectal cancer (including ISR and NOSES procedures—laparoscopic radical sphincter-preserving rectal cancer surgery with no abdominal wall incision), with the data reported and incorporated into the Colorectal Cancer Radical Surgery Database of the National Cancer Hospital, Chinese Academy of Medical and Science.

In recent years, the department has promoted the total neoadjuvant therapy (TNT) for rectal cancer, achieving a sphincter preservation rate of 98% for ultra-low rectal cancer cases—effectively preserving the anus for nearly all patients and enabling them to live with dignity. The five-year and ten-year survival rates have significantly improved.

In early 2020, a patient named Huang from Hongxiang Town, Liangzhou District, was diagnosed with ultra-low rectal cancer and insisted on being treated by the most renowned domestic expert, with an absolute requirement to preserve the anus. Unfortunately, despite extensive efforts, none of the top experts from Beijing or Shanghai could make it.

Given the urgency of the condition, Chief Physician Chen Hongbing frankly informed the family: "The surgical expertise at Wuwei Academy of Medical and Science Cancer Hospital is fully comparable to that of major hospitals nationwide. Our department has been performing laparoscopic D2 radical gastrectomy, D3 radical resection for colorectal cancer, and sphincter-preserving surgery for ultra-low rectal cancer—procedures that only a handful of top-tier hospitals in China have begun implementing. With nearly 13 years of experience and over 1,600 cases of laparoscopic colorectal surgeries, our techniques are not only highly refined but have also reached domestically advanced standards, leading the province of Gansu."

Subsequently, the patient's family, determined to seek the best hospital and surgeon, consulted multiple experts at various hospitals across the province. Every expert they consulted unanimously acknowledged that Wuwei Academy of Medical and Science Cancer Hospital had established itself as the provincial leader in oncological surgery, with its cancer surgical services having become a prestigious hallmark of the institution.

Upon returning to Wuwei, the family agreed to Chief Physician Chen Hongbing's proposed treatment plan and entrusted him with the surgery. The procedure—a conformal resection ISR sphincter-preserving operation for ultra-low rectal cancer—was successfully performed. The patient was able to get out of bed and move around on the same day postoperatively, experiencing no discomfort whatsoever, and resumed a liquid diet just three days later.

During a ward round, the patient grasped Chief Physician Chen Hongbing's hand, expressing deep gratitude: "Director Chen, you cured me without open abdominal surgery—just by making tiny incisions in my abdominal wall, and you even preserved my anus. If I hadn't experienced it myself, I wouldn't have believed it was possible!"

Chen Hongbing had long fulfilled his personal creed—"If not a renowned statesman, then a distinguished physician; one must possess virtue beyond that of a Buddha and skills surpassing those of an immortal to practice medicine." Witnessing one successful case after another of cured patients with preserved anal function, he felt immense satisfaction. Currently, he is leading Wuwei's key R&D project (Clinical Application Research on Domestic Tumai Surgical Robot in NOSES for Colorectal Cancer Radical Surgery), focusing on training and talent development to promote this advanced technology.

Introduction of Gastrointestinal Surgery

The Department of Gastrointestinal Surgery is a provincial key specialty in Gansu Province and a demonstration center for scarless laparoscopic and robotic NOSES (Natural Orifice Specimen Extraction Surgery) for gastric and colorectal cancers. Located in the Heavy Ion Therapy Campus of Wuwei Academy of Medical and Science Cancer Hospital, it focuses on the diagnosis and treatment of gastrointestinal tumors, including standardized D2 radical gastrectomy, standardized D3 radical resection for colorectal cancer, scarless laparoscopic D2 radical gastrectomy, scarless robotic D2 radical gastrectomy, scarless laparoscopic D3 radical resection for colorectal cancer, scarless robotic D3 radical resection for colorectal cancer, neoadjuvant therapy before surgery, conversion therapy, postoperative adjuvant therapy, comprehensive treatment for advanced tumors, immunotherapy, targeted drug therapy, and multidisciplinary treatment (MDT). These advanced approaches have significantly improved the five-year cure rate and survival rate of cancer patients. The department also performs extended combined organ resections and complex major tumor resections, which have notably enhanced its reputation and academic standing.

The department currently has a team of 8 specialists: 1 chief physician (Department Director Chen Hongbing, a second-level chief physician in general surgery), 1 associate chief physician, 2 master's degree holders, and 4 attending physicians/physicians. All team members have received advanced training in top medical institutions across Beijing, Shanghai, Guangzhou, Zhejiang, Fujian, and Xi'an, accumulating extensive experience in diagnosing and treating gastrointestinal tumors. The team demonstrates strong research capabilities, exceptional technical proficiency, and delivers highly precise and standardized surgical treatments, ensuring standardized management of gastric and colorectal cancers. Since February 2023, the department has pioneered robotic-assisted D2 radical gastrectomy and D3 radical resection for colorectal cancer in prefecture-level hospitals across our province. Nationally, it was the first to perform NOSES (Natural Orifice Specimen Extraction Surgery) for colorectal cancer D3 radical resection using domestically developed surgical robots. These advancements enable patients to access cutting-edge medical technology locally, significantly elevating the department's diagnostic and therapeutic standards. The department's tumor treatment capabilities have reached domestically advanced levels and provincial leading standards. It stands as one of the earliest institutions in our province to implement laparoscopic and robotic gastrointestinal tumor resections, as well as a pioneer nationwide in scarless laparoscopic and robotic NOSES procedures for colorectal cancer.

The department has authored and presented over 50 academic papers, completed seven provincial and municipal research projects, and received one first prize and three second prizes for municipal scientific and technological progress awards, as well as two third prizes for provincial scientific and technological progress awards. The team has also published two medical monographs and successfully executed one project under the National Health Commission (completed in 2022 with a research grant of 100,000 RMB). Currently, the department is leading one key R&D project in our city, titled "Clinical Application Research on Domestic Tumai Surgical Robot for NOSES in Colorectal Cancer Radical Surgery" (with a research grant of 100,000 RMB).

Chen Hongbing

Director of Gastrointestinal Surgery Department, Wuwei Academy of Medical and Science Cancer Hospital, Gansu Province

Second-Level Chief Physician

●Provincial Key Discipline Leader

● Director of Gastrointestinal Surgery and Medical Affairs Department, Wuwei Cancer Hospital

● Expert Member of Gansu Provincial General Surgery Quality Control Center

● Expert Enjoying Special Allowance for Senior Professional Technicians in Gansu Province

● Deputy Director of Colorectal Cancer Committee, Gansu Anti-Cancer Association

● Vice President of Gansu Branch Alliance, China Colorectal Cancer MDT Alliance

● Executive Director of China Rectal Cancer Sphincter-Preservation Alliance; Standing Committee Member of Gastrointestinal Oncology Committee, Chinese Anti-Cancer Association

● Deputy Director of Longyuan Gastroenterology Alliance

● Vice President of the 1st Gansu Provincial Physicians Association Oncology Branch

● Standing Committee Member of Colorectal Cancer Committee, Gansu Alliance of China Anti-Cancer Alliance

● Deputy Director of Medical Robotics Branch, Gansu Physicians Association

● Committee Member of Weight Loss and Metabolic Disorders Branch, Gansu Physicians Association

● Deputy Director of General Surgery Committee, Wuwei Medical Association

Specializes in standardized D2 radical gastrectomy and D3 radical resection for colorectal cancer; pioneered laparoscopic and robotic standardized radical surgeries for gastric and colorectal cancers, laparoscopic sphincter-preserving surgery for low rectal cancer (ISR and Bacon procedures), and laparoscopic/robotic NOSES techniques for colorectal cancer in our province 12 years ago. Completed 6 research projects, awarded 3 municipal second prizes and 2 provincial third prizes for scientific and technological progress. In 2022, successfully executed 1 project under the National Health Commission, and in 2023, led 1 key R&D program in Wuwei City.

Contact information: Chen Hongbing  13884560164

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