Robot-assisted surgery for rectal cancer in situs inversus totalis: a case report

TL;DR

A rare case of rectal cancer in a patient with situs inversus totalis was successfully treated using robot-assisted surgery.

Contribution

This case report highlights the successful application of robot-assisted surgery in a rare anatomical condition.

Findings

Robot-assisted surgery was safely performed in a patient with situs inversus totalis.

The procedure included total mesenteric excision and lymph node dissection without complications.

Postoperative recovery was uneventful with no adverse events observed.

Abstract

Situs inversus totalis (SIT) is a relatively rare congenital malformation; and particular emphasis should be placed on its anatomical recognition during surgery. Here, we report a rare case of rectal cancer in SIT, treated with robot-assisted surgery (RAS). A 71-year-old man with SIT was referred to our department with advanced rectal cancer. Robot-assisted anterior resection, using the DaVinci Xi surgical system, was performed. The ports were arranged in a normal mirror image with the camera port (2nd arm) inside the lower left abdomen. The robotic procedure of total mesenteric excision with D3 lymph node dissection was achieved, and re-roll-in of the robotic arms was implemented for anastomosis, using the double-stapling technique and additional suture reinforcement at the anastomotic site. RAS was conducted with safety and efficiency; his postoperative course was uneventful and no adverse event was observed.

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