637 Total Robotic Abdominoperineal Resection with pelvic floor reconstruction

Dr. Rajesh Kochupapy

Abdominoperineal resection (APER) for low rectal cancers is associated with significant complications, including high rates of R1 resection (10–25%) and perineal wound issues such as hernia formation. Solution: A totally robotic approach, combining abdominal and perineal teams, allows for precise tumour resection and tailored pelvic reconstruction. This synergy enhances oncological outcomes and reduces perineal morbidity. Innovative Case: A 77-year-old man was diagnosed via bowel cancer screening with a 50 mm low rectal adenocarcinoma involving the dentate line (T2N0M0). With good physiological reserve confirmed by cardiopulmonary testing, he underwent a fully robotic APR. Transabdominal transection of the levator ani ensured clear distal margins. Robotic perineal reconstruction with biological mesh was performed to reinforce the pelvic floor and promote healing. This approach demonstrates the feasibility and potential benefits of robotic synergy in complex low rectal cancer surgery.
Procedure Innovation, General Surgery, Surgical Oncology, Rectal Cancer

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