Simultaneous Resection of Rectal and Gastric Cancer with the da Vinci Single-Port System: A Case Report

The da Vinci single port (SP) system is a novel robotic surgical platform that allows multiple robotic instruments and a flexible camera to be introduced through a single umbilical incision. Compared with conventional multi-port robotic or laparoscopic approaches, it offers cosmetic advantages, reduced abdominal wall trauma, and potentially less postoperative pain. These features make it especially suitable for technically demanding gastrointestinal procedures, including simultaneous resections for synchronous malignancies.

An 81-year-old woman was referred with lower rectal cancer, staged as cT3N0M0 (Stage IIA). Preoperative investigations also identified a synchronous gastric cancer, staged as cT2N0M0 (Stage I). To minimize incision size and surgical invasiveness, the SP system was selected. A distal gastrectomy and low anterior resection were successfully performed in a single session through a single umbilical incision, supplemented by three additional ports, two of which were later used for drain placement. The operation was accomplished without intraoperative difficulties, and the patient recovered smoothly, being discharged without postoperative morbidity.

This case highlights the feasibility and safety of the SP system in simultaneous multi-organ resections for synchronous gastrointestinal cancers. The approach provides an advanced minimally invasive option that minimizes surgical trauma while maintaining oncologic adequacy.