Robotic Assisted Resection of Complex Retroperitoneal Soft Tissue Tumors in an Outpatient Setting

Gary N Mann, MD, Eelco B Wassenaar, MD, Jonathan D Harper, MD. University of Washington


Introduction: Central retroperitoneal tumors usually necessitate a major abdominal incision for their removal, with several days of inpatient recovery. This is because of their deep location and the relationship to critical viscera and major abdominal blood vessels. The purpose of this paper is to report our initial experience with robotic-assisted laparoscopic excision of these masses in an outpatient setting.
Patients: Two patients underwent robotic excision of central retroperitoneal soft tissue tumors. Both were female, 60 and 28 years of age, with an average BMI of 29 (27-32). Each tumor was incidentally detected on cross-sectional imaging done for evaluation of pain. Core needle biopsies confirmed schwannoma in both patients. One patient had a 2cm right-sided lesion that was located posterior to the inferior vena cava and below the renal vein. The second patient had a 2.7cm left-sided mass found at the junction of the aorta and the left renal vein. After discussion of options, the decision was made to excise these lesions.
Results: Surgery was uneventful, successfully performed in a minimally invasive fashion, and greatly facilitated by the da Vinci robot after respective right and left medial visceral rotation. Operative time was 123 and 163 minutes respectively, with 30cc of estimated blood loss. There were no complications, and patients were discharged the same day. Both were doing well in follow-up. Pathology confirmed schwannoma with margins free of tumor.
Conclusion: In select patients, centrally located retroperitoneal tumors can safely be resected in an outpatient setting using robotic-assisted laparoscopic techniques. 

Session Number: Poster – Poster Presentations
Program Number: P577
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