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Robotic abdominoperineal resection for T4b rectal cancer using the da Vinci SP platform

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Abstract

Purpose

The aim of the present report wasto describe a novel technique of robotic abdominoperineal resection (APR) for the treatment of T4b low rectal cancer using the da Vinci® Single-Port (SP) system (Intuitive Surgical, Sunnyvale, CA, USA).

Methods

A 3-cm transverse incision was made in the left lower quadrant of the abdomen, in the area designated for permanent colostomy. A Uniport® (Dalim Medical, Seoul, Korea) was introduced and a 25 mm multichannel SP trocar was inserted into the Uniport. A 5-mm laparoscopic assistant port was introduced on the upper midline. A video showing each step of the technique is attached.

Results

Two consecutive female patients (70 and 74 years old) underwent SP robotic APR with partial resection of the vagina 8 weeks after preoperative chemoradiotherapy. In both cases, rectal cancer was located 1 cm above the anal verge and invaded the vagina (initial stage and ymrT stage T4b). Operative time was 150 and 180 min, respectively. Estimated blood loss was 10 and 25 ml, respectively. No postoperative complications occurred. The length of postoperative hospital stay was 5 days in both cases. The final pathological stage was ypT4bN0 and ypT3N0 respectively.

Conclusions

In this first experience, SP robotic APR appears to be a safe and feasible procedure for locally advanced low rectal cancer. In addition, the invasiveness of the procedure is reduced by means of the SP system, which only requires a single incision in the area designated for colostomy. Prospective studies on a larger number of patients are necessary to confirm the outcomes of this technique compared to other minimally invasive approaches.

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Fig. 1

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Conflict of interest

The authors declare that they have no conflict of interests.

Author contributions

GSC conceived the study. HJK, AP, and SHS collected data and revised the literature. HJK and AP drafted the article. GSC critically revised the article. All authors approved the final version.

Ethical approval

All patients gave written informed consent before undergoing the procedure, for recording and publication. This study was performed in compliance with the Declaration of Helsinki.

Informed consent

All participants provided informed consent prior to their participation.

Data availability statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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Author notes

  1. A. Picciariello and H. J. Kim equally contributed to this study as the first author.

Authors and Affiliations

  1. Colorectal Cancer Center, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, 807 Hogukro, Buk-Gu, Daegu, 41404, Korea

    A. Picciariello, H. J. Kim, G.-S. Choi & S. H. Song

  2. Department of Precision and Regenerative Medicine and Ionian Area, University “Aldo Moro” of Bari, Bari, Italy

    A. Picciariello

Authors
  1. A. Picciariello
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  2. H. J. Kim
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  3. G.-S. Choi
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  4. S. H. Song
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Corresponding author

Correspondence to G.-S. Choi.

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Cite this article

Picciariello, A., Kim, H.J., Choi, GS. et al. Robotic abdominoperineal resection for T4b rectal cancer using the da Vinci SP platform. Tech Coloproctol 27, 1119–1122 (2023). https://doi.org/10.1007/s10151-023-02792-4

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  • DOI: https://doi.org/10.1007/s10151-023-02792-4

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