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Updated: Jul 3, 2026
Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
Transcontinental Telementoring of Abdominal Perineal Resection for Rectal Malignancy Complicated by Pelvic Kidney
Dobromir Dimitrov1,2, Martin Karamanliev1,2, Kun Zhou3
1Department of Surgical Oncology, University Hospital Georgi Stranski, Faculty of Medicine, Medical University - Pleven, Pleven, Bulgaria. (Drs. Dimitrov and Karamanliev).
Background:
Telementoring has emerged as a tool for bridging gaps in surgical mentorship and expertise. Its use in robotic colorectal surgery remains limited.
Case Presentation:
We report the first documented case of a robot-assisted abdominoperineal resection (APR) for rectal cancer, technically complicated by the presence of a pelvic left kidney, performed under real-time, transcontinental telementoring between China and Eastern Europe. A 61-year-old male with rectal adenocarcinoma extending to the anal canal underwent neoadjuvant chemoradiation followed by robotic APR using the da Vinci X system. Telementoring was achieved through the Proximie® platform between China and Eastern Europe. The telecommunication connection was stable, enabling real-time audio-visual and augmented-reality communications. The safety and efficiency of the surgical procedure were improved by the telementoring, and the patient recovered uneventfully and was discharged on postoperative day 5.
Conclusion:
This unique case demonstrates the technical feasibility, patient safety, and clinical utility of transcontinental telementoring in complex robotic colorectal surgery, which allows expanded global access to surgical mentorship and expertise.
