This operative video demonstrates a robotic low anterior resection with stapled colorectal anastomosis performed for rectosigmoid adenocarcinoma.

The patient is an 84-year-old woman, a retired psychiatrist, with a history of bilateral invasive ductal carcinoma of the breast treated with margin-negative bilateral modified radical mastectomy and sentinel lymph node biopsy on November 6, 2024. Her breast cancers were hormone receptor–positive (ER-positive), HER2-negative tumors, and she is currently receiving endocrine therapy with anastrozole.

She was subsequently diagnosed with pMMR well-differentiated adenocarcinoma of the rectosigmoid colon.

The patient underwent robotic staging laparoscopy followed by robotic low anterior resection, including:

• Stapled end-to-end colorectal anastomosis

• Hydropneumatic leak testing

• Flexible sigmoidoscopy for anastomotic assessment

Final pathology demonstrated:

• pT1 pN0 moderately differentiated adenocarcinoma

• 0 of 50 lymph nodes involved with carcinoma

The patient recovered well following surgery and was discharged home on postoperative day three.

This case illustrates the application of robotic minimally invasive colorectal surgery for early-stage rectosigmoid cancer, demonstrating precise pelvic dissection and oncologic lymphadenectomy with safe intracorporeal reconstruction.