Dual-docking robotic total proctocolectomy for familial adenomatous polyposis with synchronous rectal and sigmoid carcinomas: a methodology of port placement and docking strategy

Abstract Dual-docking robotic total proctocolectomy (TPC) for familial adenomatous polyposis (FAP) with synchronous carcinomas presents technical challenges in port placement, and a detailed methodology is currently lacking. This article reports a case of dual-docking robotic TPC using a detailed port placement strategy, with a description of port positions, robotic arm configurations, patient positioning, and transition steps for two independent dockings. The dual-docking procedure was successfully completed without intraoperative complications or conversion to open surgery. The first docking time was 10 min, the second docking time was 10 min, and the total operative time was 280 min. R0 resection was achieved. This single-case technical report demonstrates that the proposed dual-docking port placement strategy is technically feasible for robotic TPC-APR in a patient with FAP and synchronous carcinomas. The detailed methodology may serve as a reference for surgeons considering this approach; however, further case series and comparative studies are required to establish its generalizability, safety, and oncological efficacy.