Simultaneous totally robotic rectal resection and partial nephrectomy: case report and review of literature

Abstract

Introduction: The incidence of synchronous RCC and colorectal cancer is heterogeneous ranging from 0.03 to 4.85%. Instead, only one case of huge colon carcinoma and renal angiomyolipoma was reported. The treatment of synchronous kidney and colorectal neoplasm is, preferably, synchronous resection. Currently, laparoscopic approach has shown to be feasible and safe, and it has become the gold standard of synchronous resection due to advantages of minimally invasive surgery. We presented a case synchronous renal neoplasm and colorectal cancer undergone simultaneous totally robotic renal enucleation and rectal resection with primary intracorporeal anastomosis. As our knowledge, this is the first case in literature of simultaneous robotic surgery for renal and colorectal tumor. Case presentation: A 53-year-old woman was affected by recto-sigmoid junction cancer and a solid 5 cm left renal mass. We performed a simultaneous robotic low anterior rectal resection and renal enucleation. Total operative time was 260 min with robotic time of 220 min; estimated blood loss was 150 ml; time to flatus was 72 h, and oral diet was administered 4 days after surgery. The patient was discharged on the eighth post-operative day without peri-and post-operative complication. The definitive histological examination showed a neuroendocrine tumor pT2N1 G2, with negative circumferential and distal resection margins. Renal tumor was angiomyolipoma. At 23 months follow-up, the patient is recurrence free.

Synchronous colorectal and renal cancers: Case report and literature review

“…Another associated difficulty is the control of operative time, which can be over-understood [ 15 ]. Robotic surgery has proven to be a viable option when available [ 16 ]. In the case reported here, the choice of laparotomy was due to the lack of adequate material for video laparoscopy at the unit, and the surgery was possible mainly due to the absence of distant metastases.…”

Combined Open Prostatectomy and Kidney Surgery: Feasibility and 12-Month Outcome

“… 25 However, some groups have reported cases of combined robotic multivisceral resections like kidney and colorectal surgery for synchronous tumors or kidney and pancreatic surgery for oligometastatic kidney cancer with a synchronous pancreatic metastasis with satisfactory results. 26 , 27 Even though the sample size therefore is still small, this indicates that even extended multivisceral resections could be safely performed in a robotic manner.…”

Synchronous robotic repair of anterior diaphragmatic (Morgagni) hernia & low anterior resection for rectal cancer

“…The use of fully robotic platforms in multi‐visceral procedures has been hailed as one of the advantages of this versatile and expanding technology. There are currently a handful of published case reports and series that have reported on multi‐speciality/multi‐visceral procedures combining colorectal & urological, 1,2 colorectal & upper gastrointestinal 3 and colorectal & gynaecological 4 organs. Satisfactory outcomes such as good oncological clearance, low morbidity & blood loss and acceptable recovery times without significantly increasing surgical operative time have been reported 4 .…”