Robotic Procedure for Rare Rectal Conditions: GIST and Tailgut Cysts

Tailgut cysts and rectal gastrointestinal stromal tumors (GIST) are rare rectal tumors found in the retrorectal space. Tailgut cysts are congenital malformations resulting from incomplete regression of the hindgut during embryogenesis and they mostly affect women in the third to sixth decade of life; rectal GIST account for 5% of all GIST. Both conditions may present with nonspecific symptoms such as pelvic or anal pain, gastrointestinal bleeding or weight loss. Tailgut cysts are usually benign, but malignant lesions tend to be symptomatic and are only detected at a later stage of development. Rectal GIST have a poor overall prognosis and the rate of tumor rupture is more than four times that of nonrectal GIST. There are several treatment options, including radical resection with en-bloc excision of the mass, local excision, low anterior resection, abdominoperineal excision of the rectum (APER) and pelvic exenteration. The text discusses the advantages of robotic surgery compared to traditional open and laparoscopic methods, such as shorter length of hospital stay and faster recovery time. In addition, robotic surgery offers a particularly useful minimally invasive option for the removal of these tumors in difficult pelvic anatomy.