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KMID : 1141920200360060415
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Annals of Coloproctology
2020 Volume.36 No. 6 p.415 ~ p.416
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Robotic Partial Excision of Levator-Ani Muscle for Locally Advanced Low Rectal Cancer Invading Ipsilateral Pelvic Floor
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Yang Seung-Yoon
Kim Nam-Kyu
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Abstract
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Tumors at the level of the anorectal junction had required abdominoperineal resection (APR) to achieve an adequate resection margin. However, in the cases of tumor invading ipsilateral levator-ani muscle (LAM), en-bloc resection of the rectum with LAM including tumor would be possible. This video is to show the critical anatomic steps of this procedure. A video was produced from the robotic right partial excision of LAM (PELM) performed in a 57-year-old female patient with rectal cancer at 3 cm from the anal verge, invading the ipsilateral anorectal ring, who had received neoadjuvant chemoradiotherapy. The patient discharged at postoperative day 8 without complication. The pathology of the surgical specimen revealed ypT3N1bM0. The secure resection margin from the tumor was achieved. Robotic PELM is the sphincter-preserving technique that can be an alternative treatment option for low rectal cancer invading the ipsilateral LAM, which has been an indication for APR or extralevator APR.
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KEYWORD
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Rectal neoplasms, Robotic surgery, Levator-ani muscle
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