Simultaneous Single‐Port Robotic Liver Resection and Ileostomy Closure Using the da Vinci SP System: First Case Report

Simultaneous minimally invasive liver resection and stoma closure is frequently avoided due to concerns of intra‐abdominal contamination and increased infectious risk. The da Vinci SP system enables complex resections through a single port. We report a strategy in which the ileostomy closure site was repurposed as the primary access port for single‐port robotic liver resection. A 66‐year‐old man previously underwent low anterior resection with diverting double‐barrel ileostomy for rectal cancer followed by adjuvant chemotherapy. Surveillance imaging revealed a solitary 2.6‐cm lesion in segment 8, preoperatively considered a metastasis. Simultaneous ileostomy closure and robotic liver resection using the da Vinci SP system were performed, with one additional port for assistance and postoperative drain placement. The operation was completed without complications, and the postoperative course was uneventful. Pathology revealed mass‐forming intrahepatic cholangiocarcinoma with negative margins. This strategy may be safely implemented in selected patients.