V70 - Robotic Perineal Hernia Repair following Abdominoperineal Resection for Rectal Cancer

Saturday, May 9, 2026

On-Demand

Video Presentation(s)

Ashley Toussaint, DO

Surgery Resident
RWJUH
RWJUH
Somerset, NJ, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Author(s)

Andrew Hu, MD

General Surgery Resident
UMass Chan Medical School
University of Massachusetts T.H Chan Medical School
Worcester, MA, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.
NM

Nell Maloney Patel, MD

Professor of Surgery; Vice Chair of Education
Rutgers Robert Wood Johnson Medical School
Westfield, New Jersey, United States

Disclosure information not submitted.
Daniel L. Feingold, MD, FACS, FASCRS

Professor of Surgery
Rutgers University
New Brunswick, New Jersey, United States

Disclosure information not submitted.
Kristen Donohue, MD, FACS, FASCRS

Assistant Professor of Surgery
Rutgers Robert Wood Johnson Medical School
Atlantic Highlands, New Jersey, United States

Disclosure information not submitted.

Senior Author(s)

BS

Brendan Scully, Md

Assistant professor
Rutgers Robert Wood Johnson
New Brunswick, New Jersey, United States

Disclosure information not submitted.

All of the relevant financial relationships listed below have been mitigated.

Ashley Toussaint, DO: This individual has no financial relationships with ineligible companies.

Andrew Hu, MD: This individual has no financial relationships with ineligible companies.

Purpose/Background: Perineal hernias are a recognized complication following abdominoperineal resection (APR) for rectal cancer, particularly in patients with neoadjuvant radiation. Surgical repair of perineal hernias can be challenging due to complex anatomy, poor tissue quality and prior interventions. Robotic approaches offer potential advantages, including enhanced visualization and precision. We present a case of robotic perineal hernia repair in a patient with a history of rectal cancer treated with APR, highlighting the techniques and outcomes.

Methods/Interventions: A 62-year-old female with a history of Stage IIIB (cT3, cN1, cM0) rectal cancer underwent robotic APR with pelvic exclusion after neoadjuvant chemoradiotherapy. Six months postoperatively, she developed a perineal hernia characterized by bulging and pain. Imaging revealed infiltrated fat and a low-density collection in the perineum. The surgical procedure began with a robotic cholecystectomy for concurrent chronic cholecystitis, followed by a repair of the hernia. Multiple small defects in the levator muscles and fascia were identified and repaired using Ethibond sutures, and a Ventralight mesh was used to reinforce the pelvic floor. The uterus was mobilized and secured to the sacrum to exclude the pelvis.

Results/Outcomes: Postoperative recovery was uneventful, with complete resolution of hernia-related pain and pressure symptoms. The procedure demonstrated technical feasibility and successful reconstruction of the pelvic floor with minimal morbidity. The patient has no evidence of perineal hernia recurrence at one year.

Conclusion/Discussion: Robotic perineal hernia repair offers a feasible and effective approach for complex cases following APR. This technique allows precise defect closure, effective Mesh placement, and safe pelvic organ exclusion, resulting in favorable patient outcomes.