Single-port robotic-assisted wet colostomy after total pelvic exenteration: a feasibility video report

Background Total pelvic exenteration (TPE) is a radical procedure involving the en bloc removal of pelvic organs. Among reconstructive strategies, wet colostomy-a single conduit for both urinary and fecal diversion-offers advantages such as reduced operative time and lower risk of ureteral anastomotic complications.Objective The aim of this study was to describe a case of wet colostomy performed entirely using a single-port (SP) robotic-assisted approach, demonstrating the feasibility of this minimally invasive technique.Methods A case report study was conducted at the Gynecologic Oncology Unit of the Istituto Nazionale Tumori "Fondazione Pascale" in Italy. A pelvic recurrence of endometrial cancer was treated using the Da Vinci SP (R) robotic system. The voice-commented video article details both the TPE and reconstructive procedures. Primary outcomes included technical description, operative time, hospital stay, and blood transfusions.Results In January 2025, a 68-year-old woman with pelvic recurrence of endometrial carcinoma underwent robotic-assisted TPE with wet colostomy. The procedure lasted 320 min, with an estimated blood loss of 50 cc, requiring no transfusion. The patient was discharged on postoperative day 4 without complications within the first 30 days.Conclusion This is the first reported case of TPE with robotic SP-assisted wet colostomy. The video illustrates the surgical strategy and highlights the feasibility of this innovative technique.Synopsis This report describes the technique of single-port robotic-assisted wet colostomy following total pelvic exenteration for recurrent endometrial cancer, providing a step-by-step overview of the surgical approach.