Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 7, 2015; 21(9): 2848-2853
Published online Mar 7, 2015. doi: 10.3748/wjg.v21.i9.2848
Robot-assisted one-stage resection of rectal cancer with liver and lung metastases
Jian-Min Xu, Ye Wei, Xiao-Ying Wang, Hong Fan, Wen-Ju Chang, Li Ren, Wei Jiang, Jia Fan, Xin-Yu Qin
Jian-Min Xu, Ye Wei, Xiao-Ying Wang, Hong Fan, Wen-Ju Chang, Li Ren, Wei Jiang, Jia Fan, Xin-Yu Qin, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Author contributions: Xu JM, Wei Y, Wang XY, Fan H and Chang WJ contributed equally to this paper; all authors wrote this paper.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jian-Min Xu, MD, PhD, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, China. xujmin@aliyun.com
Telephone: +86-21-64041990 Fax: +86-21-64038038
Received: September 1, 2014
Peer-review started: September 3, 2014
First decision: October 14, 2014
Revised: October 18, 2014
Accepted: December 1, 2014
Article in press: December 1, 2014
Published online: March 7, 2015
Processing time: 188 Days and 17 Hours
Abstract

The Da Vinci Surgical System may help to overcome some of the difficulties of laparoscopy for complicated abdominal surgery. The authors of this article present a case of robot-assisted, one-stage radical resection of three tumors, including robotic anterior resection for rectal cancer, segmental hepatectomy for liver metastasis, and wedge-shaped excision for lung metastasis. A 59-year-old man with primary rectal cancer and liver and lung metastases was operated upon with a one-stage radical resection approach using the Da Vinci Surgical System. Resection and anastomosis of rectal cancer were performed extracorporeally after undocking the robot. The procedure was successfully completed in 500 min. No surgical complications occurred during the intervention and postoperative period, and no conversion to laparotomy or additional trocars were required. To the best of our knowledge, this is the first case of simultaneous resection for rectal cancer with liver and lung metastases using the Da Vinci Surgery System to be reported. The procedure is feasible and safe and its main advantages for patient are avoiding repeated operation, reducing surgical trauma, shortening recovery time, and early implementation of postoperative adjuvant therapy.

Keywords: Robotic surgery; Minimally invasive colorectal surgery; Liver metastasis; Lung metastasis; Da Vinci Surgical System

Core tip: This is believed to be the first case of simultaneous resection for rectal cancer with liver and lung metastases using the Da Vinci Surgery System. The procedure is feasible and safe and its main advantages are avoiding repeated operation, reducing surgical trauma, shortening recovery time, and early implementation of postoperative adjuvant therapy.