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Video

Session:: Ongoing Videos

V3 - Approach to Robotic LAR During Second Trimester of Pregnancy

Saturday, May 9, 2026
On-Demand

    Video Presentation(s)

  • Ryan Emanuelson, MD

    General Surgery Resident
    Swedish Medical Center
    Swedish Medical Center
    Seattle, WA, United States

    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

    • Senior Author(s)

  • Melinda E. Hawkins, MD (she/her/hers)

    Colorectal surgeon; Program Director of colorectal fellowship at Swedish Medical Center
    Swedish Medical Center First Hill Campus
    Seattle, Washington, United States

    Disclosure information not submitted.

    • Author(s)

  • BC

    Brian Carr, II, MD

    Staff Surgeon / Gratis Associate Professor
    Our Lady of the Lake Medical Center / LSU
    Baton Rouge, Louisiana, United States

    Disclosure information not submitted.

CME Eligible

Purpose/Background: This video shows a technical approach for a 39 year old female at 26 weeks gestation who presented with a near obstructing rectosigmoid colon cancer. She underwent a flexible sigmoidoscopy for chronic diarrhea and occasional bright red blood per rectum. A biopsy was obtained, which showed an invasive, MMR proficient adenocarcinoma. Staging with CT chest, abdomen, and pelvis did not show any evidence of metastasis.

Methods/Interventions: She underwent a robotic assisted low anterior resection with a colostomy. Preoperatively, a decision was made for a colostomy to prevent complications and allow for safe duration of pregnancy.

Results/Outcomes: Final pathology came back as 8.5 moderately differentiated adenocarcinoma with a TMN stage of pT3N2a with 4 of 45 positive nodes. She recovered well from surgery and delivered a healthy baby at 39 weeks gestation.

Conclusion/Discussion: Despite an N2 status, the patient elected to defer chemotherapy after discussion with medical oncology as she desired to carry her pregnancy to term, a decision that was supported by a negative post-op ctDNA