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Case Reports
. 2011 Jan;26(1):150-3.
doi: 10.3346/jkms.2011.26.1.150. Epub 2010 Dec 22.

Robot-assisted resection of paraspinal Schwannoma

Moon Sool Yang  1 , Keung Nyun Kim, Do Heum Yoon, William Pennant, Yoon Ha
Affiliations
Case Reports

Robot-assisted resection of paraspinal Schwannoma

Moon Sool Yang et al. J Korean Med Sci. 2011 Jan.

Abstract

Resection of retroperitoneal tumors is usually performed using the anterior retroperitoneal approach. Our report presents an innovative method utilizing a robotic surgical system. A 50-yr-old male patient visited our hospital due to a known paravertebral mass. Magnetic resonance imaging showed a well-encapsulated mass slightly abutting the abdominal aorta and left psoas muscle at the L4-L5 level. The tumor seemed to be originated from the prevertebral sympathetic plexus or lumbosacral trunk and contained traversing vessels around the tumor capsule. A full-time robotic transperitoneal tumor resection was performed. Three trocars were used for the robotic camera and working arms. The da Vinci Surgical System® provided delicate dissection in the small space and the tumor was completely removed without damage to the surrounding organs and great vessels. This case demonstrates the feasibility of robotic resection in retroperitoneal space. Robotic surgery offered less invasiveness in contrast to conventional open surgery.

Keywords: Neurilemmoma; Paraspinal; Retroperitoneal Space; Robotic.

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Figures

Fig. 1
Fig. 1
Enlarged mass 6 month after the initial MRI scan. Preoperative sagittal (A) and axial (B) T1 enhanced Magnetic Resonance Imaging sans showing a round encapsulated left paravertebral mass at the L4-5 level and CT angiography (C) demonstrating the location close to the aortic bifurcation (Arrow indicates tumor mass).
Fig. 2
Fig. 2
Diagram shows port placement for robot-assisted paraspinal tumor resection.
Fig. 3
Fig. 3
Operative findings of robot-assisted paraspinal tumor resection. (A) Dissection of tumor through robotic bipolar forceps and monopolar scissors (U, ureter; DL, left arm of da Vinci; DR, right arm of da Vinci; F, paracolic fat). (B) Tumor specimen (4 × 3 × 4 cm) was removed successfully with robot assisted resection.
See this image and copyright information in PMC

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