When addressing the surgical treatment of a pre-sacral tumor, resection may take place via either the conventional open approach or the more novel trans-abdominal approach with robot assistance. We present a case of a 56-year-old male who underwent the latter for an incidentally discovered 3 cm retro-rectal mass. Four port sites oriented transversely across the abdomen were used to triangulate on the pelvis. After docking of the robot and insertion of the instruments under direct visualization, dissection was carried on into the pelvis, and the rectosigmoid junction was identified. The peritoneum was incised along the right lateral aspect of the rectum and the sacral promontory was exposed. The pre-sacral space was then entered and dissection continued to the pelvic mass. The mass was circumferentially dissected from the surrounding structures, liberated from the pelvis, and removed through the 12-mm trocar site. The peritoneal defect was closed via a self-locking, absorbable suture. Patient consent was obtained for use of media for educational purposes. IRB approval was not required for this non-experimental study. The patient was successfully treated with robot-assisted trans-abdominal excision of his retro-rectal mass and was discharged home on post-operative day one. This surgical technique proved to be both safe and feasible. Continued advancement of robot-assisted surgery may show that a trans-abdominal approach to resection of pre-sacral tumors is superior to the perineal approach.

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机器人辅助腹腔镜经腹直肠直肠后切除术：病例报告

在解决-骨前肿瘤的外科手术治疗时，可通过传统的开放手术或更新颖的经腹方法在机器人协助下进行切除。我们介绍了一个病例，其中一名56岁的男性因意外发现3厘米的直肠后直肠肿块而接受了后者的治疗。横切腹部的四个端口部位用于在骨盆上进行三角剖分。在机器人对接并在直接可视化下插入器械后，将解剖切入骨盆，并识别出直肠乙状结肠连接点。沿直肠的右侧切开腹膜，并暴露骨海角。然后进入s前间隙，并继续解剖至盆腔肿块。肿块从周围结构中沿周向解剖，从骨盆中解放出来，并通过12毫米的套管针部位取出。腹膜缺损通过自锁可吸收缝合线闭合。获得患者的同意是为了将媒体用于教育目的。这项非实验性研究不需要IRB批准。该患者经机器人辅助经腹腔切除直肠后肿物成功治疗，术后第一天出院。事实证明，这种手术技术既安全又可行。机器人辅助手术的持续发展可能表明，经腹腔切除approach前肿瘤的方法优于会阴方法。获得患者的同意是为了教育目的使用媒体。这项非实验性研究不需要IRB批准。该患者通过机器人辅助经腹直肠切除术切除了直肠后的肿块，并在术后第一天出院回家。事实证明，这种手术技术既安全又可行。机器人辅助手术的持续发展可能表明，经腹腔切除approach前肿瘤的方法优于会阴方法。获得患者的同意是为了教育目的使用媒体。这项非实验性研究不需要IRB批准。该患者通过机器人辅助经腹直肠切除术切除了直肠后的肿块，并在术后第一天出院回家。事实证明，这种手术技术既安全又可行。机器人辅助手术的持续发展可能表明，经腹腔切除approach前肿瘤的方法优于会阴方法。