Abstract
BackgroundFew studies have been done on robot-assisted sacral surgery. This study aims to evaluate the outcomes of seven patients with benign sacral or presacral tumors treated with a robotic surgical system at a single center.MethodsAll patients with benign sacral or presacral tumors who underwent transperitoneal resection (between June 2015 and June 2016) using the da Vinci Si HD robotic surgical system (Intuitive Surgical Inc.) were included in this retrospective study.ResultsSeven patients with a mean age of 43.8 years (range: 22- 62 years) were included in this study. The operation time ranged from 60 to 335 min. Five out of these seven patients with presacral tumor underwent complete tumor resection by the da Vinci robotic surgical system, with a median blood loss of 52 ml. The other patients underwent excision of the presacral tumor by the da Vinci robotic surgical system, followed by a posterior approach, with a median blood loss of 675 ml. The histological diagnosis was schwannoma of the sacral nerve in five cases (71.5%). The other two cases were chordoma and solitary fibroma of the sacrum, respectively. No perioperative or postoperative complications were encountered. The average hospitalization stay was 5.7 days. No recurrences were found at follow-up 24 to 31 months later.ConclusionRobot-assisted minimally invasive sacral surgery can provide precise dissection of the tissue under a perfect view. It is a technically feasible procedure that is associated with minimal blood loss, fewer injuries and short hospitalization. It is particularly suitable for presacral benign tumors.
Highlights
Few studies have been done on robot-assisted sacral surgery
We aimed to investigate the feasibility and efficiency of the da Vinci surgical system in the resection of sacral tumors
As for benign or lowmalignancy sacral tumors when aggravating symptoms or enlargement of tumors occurs during the clinical follow-up, surgery should be taken into consideration the complicated anatomical structure, narrow space for operation in the pelvis and abundant presacral vessels make the treatment of sacral tumors extremely challenging [8,9,10]
Summary
Few studies have been done on robot-assisted sacral surgery. This study aims to evaluate the outcomes of seven patients with benign sacral or presacral tumors treated with a robotic surgical system at a single center. Primary tumors originated from sacrum or retraperitioneal area are rare. Most of them are benign or low-grade malignancies, such as chondrosarcoma and schwannoma [1, 2]. The resection of the tumor was one of the most important treatments for primary malignant sacral tumors, which could be performed using anterior, posterior, lateral and combined surgical approaches. The treatment of primary sacral tumors can be challenging because of the complex surrounding anatomical structures and the. We aimed to investigate the feasibility and efficiency of the da Vinci surgical system in the resection of sacral tumors.
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