Robot‐assisted anterior resection for rectal cancer with double inferior vena cava: A case report

Abstract

Double inferior vena cava (DIVC) is a rare but generally asymptomatic condition that is often detected incidentally by radiological examinations such as computed tomography (CT). Here, we describe the case of a 73-year-old woman with DIVC, who underwent robot-assisted surgery (RS) for rectal cancer. In this case, 3D CT angiography showed DIVC with an interiliac vein from the left common iliac vein and a tortuous aorta. Intraoperatively, we identified the presence of the left IVC in addition to the inferior mesenteric vein, gonadal vein, and ureter, which require meticulous attention during vascular processing. By optimizing the port placement, we were able to ensure mobility of the robotic arm and sufficient field of view to safely perform a robot-assisted anterior resection with lymph node dissection. Careful preoperative assessment and development of a strategy for port placement using CT imaging are essential in avoiding iatrogenic injury and performing safe RS.

Double inferior vena cava, an uncommon but relevant anatomical anomaly in surgery for lower rectal cancer: a report of two cases

“…Anterior resection of upper rectal cancer in patients with a DIVC has been previously reported [ 15 , 16 ]; however, to the best of our knowledge, resection of advanced lower rectal cancer has not. In planning advanced lower rectal cancer resection, radiation therapy or lateral lymph node dissection should be considered to reduce local recurrence.…”