COMBINED APPROACH FOR DISTAL RECTAL NEOPLASIA AND LATERAL LYMPHADENECTOMY: ROBOTIC WITH USE OF TEO

Introduction Distal rectal neoplasms represent a challenge for surgical approach, especially in cases where a manual coloanal anastomosis is required. Performing dissection of the most distal part with adequate preservation of the mesorectum can be facilitated by the minimally invasive abdominal technique combined with the use of the TEO platform for careful rectal sectioning.

Objectives In this video, we aim to demonstrate how the combination of two modern techniques can result in a more careful surgery, with proper mesorectal preservation and lateral lymphadenectomy.

Methods A 64-year-old patient with symptoms of hematochezia and diarrhea underwent colonoscopy for investigation, which indicated a lesion in the middle/distal rectum with a pathological diagnosis of adenocarcinoma. Staging MRI indicated T2N1 tumor with suspicious pelvic lateral lymph nodes on the right. An upfront surgery was chosen, performed robotically in combination with the TEO platform for proper mesorectal dissection in its most distal portion, without violation.

Results The use of robotics for the abdominal portion allows for careful and precise dissection, and the TEO platform facilitates sectioning under visual control of the anal canal, preserving tissues and ensuring a safer subsequent coloanal anastomosis.

Conclusion The combined approach of modern techniques can provide careful mesorectal dissection and prevent its violation, which is one of the principles in the oncologically adequate treatment of rectal cancer. When available, their combination can promote an intact surgical specimen.

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
25 April 2025