Abstract Although the lithotomy or Lloyd–Davies position is standard for laparoscopic or robotic abdominoperineal resection for lower rectal cancer, visualization and instrument maneuverability can be limited in cases involving bulky tumours with invasion of adjacent organs. We report a case of a bulky rectal cancer with uterine invasion that was successfully resected via the perineal approach, with excellent visualization achieved using the right lateral decubitus position.
Uchiyama et al. (2025) studied this question.