Heather M Emmerton-Coughlin, MD, FRCSC, Christopher M Schlachta, BSc, MDCM, FRCSC, FACS, Ahmed Almamar, MD, MSc, FRCSC, Newar Alkhamesi, MD, PhD, FRCSGEN, SURG, FRCS, FRCSEd, FRCSC. Western University and London Health Sciences Centre
Extralevator excision of the rectum has been shown to improve margin negativity in abdominoperineal resection. This can be technically challenging, and the resultant pelvic floor defect can make adequate closure difficult. Here we present a hybrid laparoscopic and robotic extralevator abdominoperineal excision of the rectum with pelvic floor reconstruction using biologic mesh. This approach facilitates pelvic dissection and perineal closure while maintaing acceptable hernia, wound and pelvic complication rates.