International Cancer Conference Journal

, Volume 8, Issue 4, pp 141–145 | Cite as

Simultaneous robotic surgery with low anterior resection and prostatectomy/hysterectomy

  • Yoshiro ItataniEmail author
  • Kenji Kawada
  • Koya Hida
  • Susumu Inamoto
  • Rei Mizuno
  • Saori Goto
  • Yoshihisa Okuchi
  • Tomoaki Okada
  • Yoshiharu Sakai
Video article


Cooperation with multiple departments is essential for the treatment of patients with rectal cancer and other pelvic cancers. In our department, we experienced two cases of rectal cancer that underwent robotic low anterior resection (LAR) and simultaneous resection of other pelvic organs (case 1 with prostatectomy and case 2 with hysterectomy) using the da Vinci Xi system. Here, we show the precise procedures of these two robotic surgeries. Under general anesthesia and lithotomy position, five da Vinci ports were symmetrically placed along the umbilical horizontal line with a 7 cm interval, and a 5 mm AirSeal Access Port was added in the right or left upper quadrant. Patients were placed with 22-degree Trendelenburg and 8-degree tilt to the right. The operators used the center port on the umbilicus as a camera port and chose the docking arms with either two-left-one-right or one-left-two-right setting depending on their preference. This port setting was quite useful for the operators from multiple departments to change the docking arms, even if their preference may be different. Moreover, assistants could use the remaining two ports to provide a well-expanded and safer surgical field. “With a familiar view” and “with a wide view” are our two concepts to safely perform extended pelvic surgeries. We have employed this symmetrical horizontal port site position as a general setting for usual rectal surgeries.


Robot-assisted surgery Simultaneous resection Rectal cancer Prostatectomy Hysterectomy 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participants and/or animals

For this type of study, formal consent is not required.

Informed consent

Written informed consent was obtained from both patients for publication of this case report. Copies of the documents are available for review by the Editor-in-Chief of the journal.

Supplementary material

13691_2019_377_MOESM1_ESM.mpg (380.5 mb)
Supplementary material 1 (MPG 389607 kb)


  1. 1.
    Kim CW, Kim CH, Baik SH (2014) Outcomes of robotic-assisted colorectal surgery compared with laparoscopic and open surgery: a systematic review. J Gastrointest Surg 18(4):816–830CrossRefGoogle Scholar
  2. 2.
    Yamaguchi T, Kinugasa Y, Shiomi A, Kagawa H, Yamakawa Y, Furutani A, Manabe S, Yamaoka Y, Hino H (2018) Oncological outcomes of robotic-assisted laparoscopic versus open lateral lymph node dissection for locally advanced low rectal cancer. Surg Endosc 32(11):4498–4505CrossRefGoogle Scholar
  3. 3.
    Shiomi A, Kinugasa Y, Yamaguchi T, Kagawa H, Yamakawa Y (2016) Robot-assisted versus laparoscopic surgery for lower rectal cancer: the impact of visceral obesity on surgical outcomes. Int J Colorectal Dis 31(10):1701–1710CrossRefGoogle Scholar
  4. 4.
    Yamaguchi T, Kinugasa Y, Shiomi A, Tomioka H, Kagawa H, Yamakawa Y (2016) Robotic-assisted vs. conventional laparoscopic surgery for rectal cancer: short-term outcomes at a single center. Surg Today 46(8):957–962CrossRefGoogle Scholar
  5. 5.
    Menon M, Tewari A (2003) Robotic radical prostatectomy and the Vattikuti Urology Institute technique: an interim analysis of results and technical points. Urology 61(4 Suppl 1):15–20CrossRefGoogle Scholar
  6. 6.
    Mandai M (2013) Application of robot-assisted surgery in nerve-sparing radical hysterectomy for uterine cervical cancer. Acta Med Kinki Univ 38(1):1–5Google Scholar

Copyright information

© The Japan Society of Clinical Oncology 2019

Authors and Affiliations

  1. 1.Department of Surgery, Graduate School of MedicineKyoto UniversityKyotoJapan

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