Laparoscopic Resection of Recurrent Cervical Cancer Infiltrating the Low Rectum

Luigi Boni, MD, FACS

Product Details
Product ID: ACS-6025
Year Produced: 2020
Length: 7 min.


This video shows our technique to perform laparoscopic resection of recurrent cervical cancer infiltrating the low rectum. The patient is a 51-year-old woman, who underwent an open hysterectomy for a cervical intraepithelial neoplasia stage III 13 years before. After a gynecologic examination, abdominal MRI confirmed the presence of a 53x51x49 mm irregular pelvic mass infiltrating rectal wall and vaginal wall. The colonoscopy confirmed a 5 cm stenotic rectal lesion. The pathology report was in keeping with squamous cell carcinoma and confirmed the suspicion of a recurrent cervical cancer. The patient was scheduled for a laparoscopic resection of the tumor in supine lithotomy position and four trocars were used. After opening left peritoneum, the left ureter was dissected from the pelvic mass. The upper and mid mesorectal dissection was performed and the rectum was divided through a surgical stapler. Subsequently, the right ureter was dissected from the mass. The opening of the vaginal wall confirmed tumoral infiltration of the rectal wall and the posterior wall of the vagina. Therefore, mesorectal dissection was completed up to the level of the pelvic floor and the lower rectum was divided using a surgical stapler, removing en-bloc the pelvic mass, the rectum and vaginal posterior wall. The specimen was extracted through a Pfannenstiel incision with an endobag. After indocyanine green perfusion control, end-end colo-rectal anastomosis was performed. Lateral ileostomy was fashioned. The postoperative course was uneventful and the patient was discharged on postoperative day 6. Histopathological examination reported the presence of squamous cell carcinoma.