Robotic-assisted resection of a rectal mass with situs inversus totalis using the Da Vinci system:a case report and literature review
10.7659/j.issn.1005-6947.250080
- VernacularTitle:达芬奇机器人辅助切除完全内脏移位症并直肠占位1例报告并文献复习
- Author:
Shaojun YIN
1
;
Hailong YANG
1
;
Guixian WANG
1
;
Zhen LI
1
;
Weitang YUAN
1
;
Kunkun XIA
1
Author Information
1. 郑州大学第一附属医院结直肠肛门外科,河南郑州 450052
- Publication Type:Journal Article
- Keywords:
Rectal Neoplasms;
Heterotaxy Syndrome;
Robotic Surgical Procedures
- From:
Chinese Journal of General Surgery
2025;34(4):778-786
- CountryChina
- Language:Chinese
-
Abstract:
Background and Aims:Complete situs inversus(SIT)is a rare congenital abnormality of organ mirror-image arrangement,presenting certain challenges for abdominal surgical procedures.The Da Vinci robotic system,with its high-definition 3D vision and flexible operation,holds potential for application in patients with anatomical variations.This report presents the diagnosis and treatment process of a patient with rectal mass and SIT who underwent robotic-assisted surgery.Additionally,relevant literature is reviewed to provide insights for individualized surgical strategies in patients with complex anatomical variations and to promote the further clinical application of robotic-assisted surgery systems.Methods:A case from the First Affiliated Hospital of Zhengzhou University is reported,in which a patient with rectal mass and SIT successfully underwent lesion resection using the Da Vinci robotic system with an unconventional"five-port"technique.A systematic literature review was also conducted(including 35 case reports),to summarize the surgical characteristics of colorectal procedures in SIT patients and the advantages of robotic system application.Results:The patient was a 74-year-old male who presented with rectal bleeding.Imaging confirmed the diagnosis of SIT,and colonoscopy revealed a large polypoid mass with ulceration at the apex,located 13-18 cm from the anal verge.The patient subsequently underwent Da Vinci robotic-assisted resection of the rectal lesion.The robotic system effectively overcame the challenges posed by mirror-image anatomy,enabling complete excision of the lesion.The operation lasted 183 minutes,with intraoperative blood loss of less than 20 mL.Postoperative pathology confirmed a villous tubular adenoma with high-grade intraepithelial neoplasia.The patient had an uneventful recovery,and no recurrence was observed during the 9-month follow-up.Literature analysis demonstrated that the robotic system,through magnified 3D visualization,flexible instrument articulation,and tremor filtration,significantly improves surgical precision in patients with anatomical anomalies.Conclusion:The Da Vinci robotic system effectively addresses the challenges of anatomical variations related to SIT in low rectal surgery.Its stability and precision offer a new technical option for tumor resection under complex anatomical conditions,demonstrating clinical value for widespread application.
