Robot-assisted anterior resection of rectal cancer in a patient with abdominal aortic aneurysm using a monitoring laparoscope: a case report.

IF 1.7 Q2 MEDICINE, GENERAL & INTERNAL
Annals of Medicine and Surgery Pub Date : 2025-02-11 eCollection Date: 2025-02-01 DOI:10.1097/MS9.0000000000002936
Junpei Takashima, Hirotoshi Kobayashi, Ayaka Koizumi, Fumi Shigehara, Kenji Yamazaki, Daisuke Fujimoto, Fumihiko Miura, Keizo Taniguchi
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Abstract

Introduction and importance: We present the first case of robot-assisted anterior resection for rectal cancer in a patient with abdominal aortic and common iliac aneurysms using a monitoring laparoscope for enhanced safety.

Case presentation: An 86-year-old man presented with bloody stool and was diagnosed with Stage IIIB rectal cancer (T3N1aM0). Preoperative computed tomography revealed a 39-mm abdominal aortic aneurysm and 25-mm left common iliac aneurysm. Robot-assisted anterior resection with D2 lymph node dissection was performed using a 5-mm laparoscope to avoid contact between robotic forceps and aneurysm. The procedure was successful, and he was discharged from the hospital on the ninth postoperative day.

Clinical discussion: Robotic surgery, owing to the lack of tactile sensation, is generally contraindicated in cases of abdominal aortic aneurysms because of the risk of vascular injury. However, this case demonstrates that real-time monitoring with a 5-mm laparoscope can effectively prevent accidental vascular injury during robotic surgery for rectal cancer.

Conclusion: This case illustrates the appropriate modifications by which robotic surgery for rectal cancer can be safely performed in patients with abdominal aortic or common iliac artery aneurysms.

机器人辅助腹主动脉瘤患者直肠癌前切除术1例。
简介和重要性:我们报告了第一例机器人辅助直肠癌前切除术患者,该患者患有腹主动脉瘤和普通髂动脉瘤,使用腹腔镜监测以提高安全性。病例介绍:86岁男性,以大便带血,诊断为IIIB期直肠癌(T3N1aM0)。术前计算机断层扫描显示39毫米的腹主动脉瘤和25毫米的左髂总动脉瘤。为了避免机器人钳与动脉瘤接触,在5mm腹腔镜下进行机器人辅助前切除术并清扫D2淋巴结。手术很成功,他于术后第九天出院。临床讨论:由于缺乏触觉,机器人手术在腹主动脉瘤的病例中一般是禁忌的,因为有血管损伤的风险。然而,本病例表明,在机器人直肠癌手术过程中,5mm腹腔镜实时监测可以有效预防意外血管损伤。结论:本病例说明了在腹主动脉瘤或髂总动脉瘤患者中,通过适当的改进,机器人手术可以安全地进行直肠癌手术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Annals of Medicine and Surgery
Annals of Medicine and Surgery MEDICINE, GENERAL & INTERNAL-
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5.90%
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1665
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