31: Robotic-assisted resection of a 10 cm retroperitoneal pelvic ganglioneuroma

Abstract

This video demonstrates the surgical resection of pelvic Ganglioneuroma located in right retroperitoneal space using robotic platform. Ganglioneuroma (GN) are benign tumors of the sympathetic nervous system that arise from embryonic crest cells. They originate along the sympathetic chain and frequently involve the mediastinum, retroperitoneum, and adrenal glands. Symptoms occur as a result of mass compression of surrounding organs or nerve plexuses. When feasible, surgical excision is the preferred treatment modality. Herein we report a case involving robotic-assisted resection of a 10 cm retroperitoneal GN surrounding major pelvic vasculature. The patient is a 64-year-old female who presented with right lower quadrant abdominal pain and constipation. MRI revealed a right, non-enhancing, retroperitoneal mass adjacent to the right iliac vessels and distinctly separate from the right ovary. Right pelvic lymphadenopathy was also noted. Total operative time for the robotic-assisted resection was 96 minutes. Minimal blood loss was noted. Patient was discharged home on post-operative day one. Pathology revealed a right retroperitoneal GN. All pelvic lymph nodes were negative. Her postoperative MRI revealed no residual tumor. To our knowledge this is the first reported case of a robotic-assisted resection of GN. The application of robotic surgery for complete and safe resection of a rare retroperitoneal tumor such as GN is an acceptable approach with less sustained blood loss and shorter hospital stay.