The First Affiliated Hospital of Xiamen University Successfully Performs Da Vinci Robot-Assisted Single-Port Radical Resection for Rectal Cancer

Rectal cancer is a prevalent gastrointestinal malignancy. Conventional surgical approaches are associated with significant drawbacks including substantial trauma, limited operative exposure and prolonged recovery. To break through the bottleneck of minimally invasive treatment, the Department of Colorectal Surgery team at The First Affiliated Hospital of Xiamen University performed the first single-port robotic-assisted radical resection of rectal cancer in Fujian Province. This achievement fills the provincial technical gap and delivers an advanced, precise, minimally invasive and cosmetically favorable surgical option for patients with rectal tumors.

01 Bloody Stool Leads to Tumor Diagnosis, Elderly Patient Faces Surgical Challenges

A 61-year-old patient, Mr. Dai, presented with bright red hematochezia lasting for 15 consecutive days. After noticing the abnormality, he sought care at a local hospital. Colonoscopy revealed a rectal mass. For definitive and specialized treatment, the patient was referred to the Department of Colorectal Surgery, The First Affiliated Hospital of Xiamen University, under the care of Professor Su Guoqiang, academic leader of the department.

Digital rectal examination identified a cauliflower-like mass 7 cm from the anal verge, confirming a diagnosis of mid rectal cancer. Further examinations showed the tumor measured approximately 4 cm in diameter. The large tumor size combined with a narrow pelvic cavity created a confined surgical space, rendering conventional surgery highly challenging.

Constrained by tumor location, lesion size and anatomical conditions, traditional open surgery and multi-port laparoscopic surgery require large incisions and multiple puncture sites. These approaches carry greater trauma, higher risks of postoperative complications and longer recovery periods, imposing severe physical and psychological burdens on patients.

02 Customized Treatment Plan, MDT Team Overcomes Surgical Barriers

To achieve complete tumor resection, minimize surgical trauma and preserve postoperative quality of life, Professor Su Guoqiang’s team launched a multidisciplinary team (MDT) consultation. Combined with the patient’s age, tumor characteristics and anatomical features, a tailored plan of single-port robotic-assisted radical rectal cancer resection was formulated.

Professor Su Guoqiang performed the main operation, with Professor Chen Qionghua, Vice President of the hospital, providing intraoperative guidance. Drawing on extensive experience in robotic single-port gynecologic oncology surgery, the team completed assembly of the single-port access (PORT) system and placement of robotic arms. Adhering strictly to the principle of total mesorectal excision (TME), the team achieved en bloc tumor resection and complete three-field lymph node dissection to meet radical oncological standards.

Intraoperative blood loss was minimal. Dissection was precise and standardized, and the resected specimen maintained intact mesorectum. The procedure achieved complete eradication of the tumor while preserving anal function, fulfilling both oncological cure and organ preservation goals.

03 Single-Port Robotic Surgery: Breaking Limitations of Traditional Minimally Invasive Techniques

Compared with conventional single-port laparoscopy, the da Vinci single-port robotic system eliminates the “chopstick effect” caused by instrument interference, offering prominent advantages for pelvic surgery within confined spaces:

  • Faster establishment of the surgical access and flexible instrument angulation suitable for operations in narrow body cavities
  • Three-dimensional magnified surgical visualization for clear identification of lesions, blood vessels and nerves, improving surgical precision
  • Robotic arms enable dexterous grasping, cutting, hemostasis and suturing, overcoming the physical limitations of human hands
  • Reduced trauma, concealed postoperative scars and accelerated recovery, balancing therapeutic efficacy and cosmetic outcomes

The operation adopted a 3 cm concealed periumbilical incision. The single-port PORT system supported all surgical steps, specimen extraction and wound management without additional trocar punctures. This technique lowers the risk of abdominal wall incision tumor seeding and reduces postoperative pain associated with multiple trocar sites, aligning with enhanced recovery after surgery principles.

In addition, robotic surgery enables precise identification and preservation of critical pelvic nerves and blood vessels, substantially reducing the incidence of postoperative urinary and sexual dysfunction to protect patients’ long-term quality of life. The single-port PORT system keeps trocars outside the peritoneal cavity, creating an adequate surgical triangulation. This facilitates thorough abdominal exploration, precise lymph node dissection and expansion of the surgical dissection plane for safer operations.

04 Rapid Postoperative Recovery Validates Advanced Minimally Invasive Expertise

Benefiting from precise and minimally invasive manipulation, Mr. Dai recovered smoothly without complications. Successful anal preservation was achieved, and the patient was discharged on postoperative day 6.

This operation represents the first of its kind performed at The First Affiliated Hospital of Xiamen University, with no relevant literature reported within Fujian Province to date. It marks a new milestone in the hospital’s minimally invasive colorectal oncology program and demonstrates provincial leading technical capability.

Professional Insight: Rectal Cancer Surgery Enters the Era of Single-Port Robotic Minimally Invasive Treatment

According to Professor Su Guoqiang, surgical management of rectal cancer has fully entered the minimally invasive era. Conventional laparoscopic rectal cancer surgery requires five trocar punctures, which compromise abdominal aesthetics and raise risks of incision infection, pain and adhesion.

Although conventional single-port laparoscopy reduces the number of incisions, severe instrument clashing, limited visual field and high technical requirements restrict its widespread adoption.

The da Vinci single-port robotic platform addresses these challenges. Powered by three-dimensional visualization, wristed robotic instruments and ergonomic human-machine control, it eliminates the “chopstick effect”. It is well suited for rectal cancer surgery with narrow pelvic cavities, deep lesions and limited operative space. It delivers radical resection, minimal trauma, organ preservation, inconspicuous scars and accelerated recovery, serving as a state-of-the-art minimally invasive option for colorectal malignancies.

 

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