VM106 - EXPERTS Assisted Robotic Abdominoperineal Resection of the Rectum in a High Risk Morbidly Obese Patient in the Supine Position

Purpose/Background: An extraperitoneal approach to colorectal surgery has been shown to be safe and feasible in patients with left sided colon cancer ( doi: 10.1245/s10434-022-12848-8 and https://doi.org/10.1093/bjs/znad173 )

This video demonstrates the specific benefits of this technique in high risk patients to reduce cardiovascular and respiratory morbidity by performing the surgery in the supine extraperitoneal position

Methods/Interventions: An extraperitoneal approach has been combined with a robotic approach for this high risk 76 year old male patient with low rectal cancer treated initially with neoadjuvant short course radiotherapy.

Results/Outcomes: The supine position with straight legs helped to reduce the cardiovascular and respiratory morbidity in this patient.

Conclusion/Discussion: The extraperitoneal approach to colorectal surgery could be particularly beneficial in high risk patients to avoid the head down, elevated leg position in conventional surgery