Synchronous robotic repair of anterior diaphragmatic (Morgagni) hernia & low anterior resection for rectal cancer

Abstract

Background:We present the case report of synchronous trans-fascial repair of a large congenital Morgagni hernia (MH) and low anterior resection using a fully robotic approach.Methods: A 61-year old female presented with fresh red blood in her stool. She had a previous history of abdominal hysterectomy and a performance status of 0. Imaging revealed a low rectal cancer and incidental large MH.Results: Using the Da Vinci X platform the procedure was successfully performed; total operating time of 450 min, <200 ml blood loss and 5 days hospital stay. Postoperative scan at 6 months, 1 and 2 years showed no evidence of hernia or cancer recurrence. Conclusion:We have demonstrated that complex multi-visceral procedures can be safely performed on fully robotic platforms, even in previously disturbed surgical fields. The robotic approach may provide the opportunity for seamless multispeciality operating simultaneously in multiple body cavities.