Consultant Princess Margaret Hospital Hong Kong, Hong Kong
All of the relevant financial relationships listed below have been mitigated. This individual has no financial relationships with ineligible companies.
All of the relevant financial relationships listed below have been mitigated.
Sabrina Wong: This individual has no financial relationships with ineligible companies.
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Purpose/Background: This video abstract aims to demonstrate the application of robotic surgery in locally advanced colon cancer including techniques of complete mesocolic excision and intracorporeal anastomosis.
Methods/Interventions: A case of robot assisted right hemicolectomy with en-bloc wedge resection of the duodenum was reviewed.
Results/Outcomes: A 58-year-old lady was diagnosed with cancer of the ascending colon with invasion to the second part of duodenum. Tumor biopsy showed mismatch repair protein deficiency. She underwent 10 cycles of pembrolizumab with follow-up computed tomography scan showing shrinkage of tumor. Robot assisted right hemicolectomy with en-bloc wedge resection of the duodenum was done. Complete mesocolic excision was performed. Intracorporeal anastomosis was done in Delta configuration. The operation duration was 360min and blood loss 50ml. She recovered well with no complications noted. Histology of the specimen including 39 lymph nodes showed pathological complete response. She remained disease free at 9 months of follow-up.
Conclusion/Discussion: This is a case of locally advanced cancer of the ascending colon with pathological complete response after immunotherapy. Application of minimally invasive surgery is feasible to reduce post-operative morbidity.
