Robot-Assisted Ileocecal Resection After Endovascular Aneurysm Repair for Abdominal Aortic Aneurysm: A Case Report Focusing on Technical Strategies to Minimize Graft-Related Stress.

A 79-year-old woman with a history of endovascular aneurysm repair (EVAR) for a large abdominal aortic aneurysm underwent robot-assisted ileocecal resection (R-ICR) for ascending colon cancer. Several technical modifications, including modified port placement, operative sequence adjustment, and strict intraoperative blood pressure control, were implemented to minimize inadvertent stress on the stent graft. The procedure was completed without vascular complications, and the postoperative course was uneventful. Although robot-assisted surgery increases the risk of mechanical aneurysmal compression and lacks tactile feedback, these technical modifications enabled safe procedural completion. R-ICR after EVAR with appropriate technical modifications and perioperative management may be feasible in select patients.