# Excision of a bulky rectal cancer with uterine invasion via a perineal approach in the right lateral decubitus position: a case report

## TL;DR

A new surgical position improved visibility and access during the removal of a large rectal tumor that had spread to the uterus.

## Contribution

The right lateral decubitus position enhances perineal approach surgery for bulky rectal cancers with uterine invasion.

## Key findings

- The right lateral decubitus position provided excellent visualization during the perineal resection.
- The approach successfully resected a bulky rectal cancer with uterine invasion.
- This method may improve surgical outcomes in complex rectal cancer cases.

## Abstract

Although the lithotomy or Lloyd–Davies position is standard for laparoscopic or robotic abdominoperineal resection for lower rectal cancer, visualization and instrument maneuverability can be limited in cases involving bulky tumours with invasion of adjacent organs. We report a case of a bulky rectal cancer with uterine invasion that was successfully resected via the perineal approach, with excellent visualization achieved using the right lateral decubitus position.