Robot-assisted Laparoscopic Ileocecal Resection for a Patient with Advanced Cecal Cancer and a Ventriculoperitoneal Shunt—A Case Report—

Abstract

A 78-year-old man was referred to our hospital with ascending colon cancer that was detected by colonoscopy performed during investigation of anemia. He had previously been diagnosed with a subarachnoid hemorrhage, after which a ventriculoperitoneal shunt (VPS) was placed for secondary hydrocephalus. After consultation with the neurosurgery team, the decision was made to perform surgery without removing the VPS. The patient was placed in the supine position with a slight Trendelenburg (5°) and 5° left tilt. Pneumoperitoneum was maintained at a lower-than-usual pressure of 8 mmHg. The VPS tube was guided outside the abdominal cavity during surgery because it interfered with the operation. Robot-assisted laparoscopic ileocecal resection with D3 lymphnode dissection was performed safely. An extracorporeal ileocolonic anastomosis using a stapling device was performed to prevent intra-abdominal contamination. The patient's postoperative course was uneventful, and the patient was discharged without complications. Robot-assisted laparoscopic ileocecal resection may be a suitable surgical procedure for patients with a VPS, but further cases need to be evaluated.