Usefulness of real-time navigation using intraoperative ultrasonography for rectal cancer resection.

Introduction: At our institute, we usually perform robot-assisted surgery for rectal cancer as minimally invasive surgery. It is necessary to recognize the tumor edge accurately when deciding where to place the distal cutting line of the rectum. In this article, with video presentation, we demonstrate the usefulness of intraoperative sonography (IOUS) for detecting the rectal tumor site in robotic surgery. This is the first report to discuss the IOUS image of rectal cancer.

Materials And Surgical Technique: After mobilization of the rectum in robotic procedure, the rectum should be straightened. Drop the laparoscopic ultrasonography probe through the 12-mm assistant port and place it at the anterior wall of the rectum. By presenting operative and ultrasound findings simultaneously on a single monitor, the operator can recognize the tumor location accurately and decide on the cutting line. We report three cases in the supporting video presentation.

Discussion: Rectal tumors can be detected by IOUS, and this modality is effective for determining the cutting line of the rectum. Real-time navigation by IOUS can be performed noninvasively and easily, so it is expected to be helpful in cases of robotic rectal cancer resection.