V65 - Robotic Low Anterior Resection for Locally Advanced Rectal Cancer in a Male-to-Female Transgender Patient

Saturday, May 9, 2026

On-Demand

Video Presentation(s)

RB

Ruxandra-Maria Bogdan, MD

General Surgery Resident
Queen's University at Kingston
Kingston, Ontario, Canada

All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no financial relationships to disclose

Author(s)

SR

Sherwin Rajkumar, MD

General Surgery Resident
Queen's University at Kingston
Kingston, Ontario, Canada

Disclosure information not submitted.
SP

Sunil V. Patel, MD, DPhil, FRCSC

Associate Professor
Queen's University at Kingston
Kingston, Ontario, Canada

Disclosure information not submitted.

Senior Author(s)

AF

Ameer Farooq, MD, MPH, FRCSC

Assistant Professor
Queen's University at Kingston
Kingston, Ontario, Canada

Disclosure information not submitted.

CME Eligible

Purpose/Background: This is a late 60s female patient with sigmoid adenocarcinoma. She had previously undergone gender affirming surgery and had a penile inversion vaginoplasty with a neovagina located approximately between the prostate and rectum. She was discussed at multidisciplinary cancer conference and it was felt the tumor would amenable to a "straight to surgery" approach.

Methods/Interventions: The patient proceeded to surgery and underwent an uncomplicated robotic low anterior resection with intracorporeal anastomosis. During the resection, special consideration was given to the anterior plane, and extra care was taken to avoid damaging the neovagina. Dilators were inserted intermittently into the neovagina intermittently during the dissection to help guide the operation.

Results/Outcomes: Successful completion of low anterior resection, without surgical complications. Patient was discharged home within a couple of days.

Conclusion/Discussion: Colorectal surgeons must have an understanding of the altered pelvic anatomy after gender-affirming surgery when considering surgery for rectal cancer. Careful review of previous operative records is critical. Frequent intra-operative exams can help maintain orientation.