Robotic-assisted transanal total mesorectal excision (R-TaTME) has unique advantage in low rectal cancer. Single incision plus oneport (SIPOP) laparoscopic operation can synchronously cooperate with robotic-assisted transanal operation, in order to the difficulty of operation, improve the quality of operation and shorten the time of operation. A retrospective analysis was conducted on the clinical and pathological data of one patient who underwent SIPOP synchronously combined with R-TaTME + sigmoid-anal anastomosis + ileostomy at the Department of General Surgery, Army Characteristic Medical Center on September 11, 2019. This 71-year-old patient was male with body mass index of 24.08 kg/m(2) and received preoperative chemotherapy. Rectal adenocarcinoma was confirmed by colonoscopy biopsy, and distance from tumor lower edge to anal verge was 3 cm. MRI indicated T2N1 stage. The operation was completed successfully, and the transabdominal and robotic transanal surgery totaled 117 minutes, with 15 minutes for the robotic transanal preparation step. There was about 20 ml of intraoperative blood loss and no blood transfusion was performed. The patient was discharged 6 days after operation. No intraoperative or postoperative complications occurred. The postoperative TNM staging was stage I (pyT2N0cM0). No recurrence or metastasis was found at postoperative 7 month. It is a safe, effective and feasible technique for patients with low rectal cancer.
机器人在低位直肠癌经肛操作独具优势，同步联合单孔加一孔腹腔镜手术经腹操作可与机器人经肛组相互配合，降低手术难度，提高手术质量，缩短手术时间。本文回顾性分析陆军军医大学特色医学中心普通外科于2019年9月11日行1例单孔加一孔腹腔镜经腹同步联合机器人经肛全直肠系膜切除+乙状结肠肛管吻合+回肠预防性造口患者的临床及病理资料：71岁男性，体质指数24.08 kg/m(2)，活检示直肠腺癌，肿瘤下缘据肛缘3 cm, MRI显示为T(2)N(1)期;术前行新辅助放化疗。手术顺利，机器人经肛对接15 min，经腹、经肛同步进行手术时间共计117 min。术后第6天出院。无术中及术后并发症发生。术后TNM分期为Ⅰ期（pyT(2)N(0)cM(0)期）。随访至术后7个月，暂未发现复发、转移。实践证明单孔加一孔腹腔镜经腹同步联合机器人经肛全直肠系膜切除术安全有效、可行。.
Keywords: Laparoscopic surgery, Single incision plus one port; Rectal neoplasms, Low position; Robotic surgery; Total mesorectal excision, trananal, transabdominal.