Robotic Anterior Resection in a Patient with Multiple System Atrophy

Multiple system atrophy (MSA) is a rare, progressive neurodegenerative disorder characterised by autonomic dysfunction, cerebellar ataxia and parkinsonism. Based on the clinical presentation, it is categorised as MSA-parkinsonian (MSA-P) and MSA-cerebellar (MSA-C) variants. The condition presents significant perioperative challenges, particularly in patients undergoing major surgical procedures. A thorough understanding of the disease’s pathophysiology, along with careful pre-operative planning and optimisation of intraoperative and post-operative monitoring, are the keys to enhancing patient outcomes. We report the successful perioperative management of a 64-year-old male with MSA-C undergoing robotic-assisted laparoscopic anterior resection with a stoma for carcinoma rectum under general anaesthesia.