Robotic Abdominoperineal Resection With Enmass Prostatectomy For Synchronous Primary

This video was entered into the 2020 KS National Robotic Surgery Video Awards: Robotic Abdominoperineal Resection With Enmass Prostatectomy For Synchronous Primary

Abstract- Sanket Subhash Bankar: Introduction: In this video we demonstrate the feasibility of robotic surgery for patients with synchronous rectal and prostate cancer planned for abdominoperineal resection with enmass prostatectomy. Objectives: To demonstrate systematic approach for performing robotic abdominoperineal resection with enmass prostatectomy for synchronous rectal and prostate cancer. Methods: A 70 years old gentleman presented to us with per rectal bleeding and altered bowel habits since 10 months. Per rectal examination revealed growth at 3cm from anal verge with biopsy suggestive of moderately differentiated adenocarcinoma. Magnetic resonance imaging (MRI) pelvis showed mid rectal lesion abutting right seminal vesicle with a separate lesion in right lobe of prostate. Prostate biopsy was prostatic adenocarcinoma with Gleason’s score of 3+4=7. Metastatic workup was negative. He received neoadjuvant chemoradiation (NACTRT) 60GY/25#. A reassessment MRI scan was suggestive of rectal primary with maintained planes with seminal vesicles with prostatic lesion involving right seminal vesicle. This patient underwent robotic abdominoperineal resection with enmass prostatectomy with bilateral pelvic lymph node dissection with permanent suprapubic catheterisation. Results: The surgery was uneventful with an operative time of 400 minutes. Postoperative course was uneventful and patient was discharged on post-operative day 7. Conclusions: Robotic abdominoperineal resection with enmass prostatectomy can be safely and effectively performed for synchronous rectal and prostate cancers.

Robotic Surgery video, narrated, with PPT’s, CT imaging, diagrams 07:57