Pamela A Rudnicki, MD, Ramon A Brown, MD. Keesler Medical Center, Keesler Air Force Base
Introduction: When addressing the surgical treatment of a pre-sacral tumor, resection may take place via either the conventional open approach or the more novel trans-abdominal approach with robot assistance. We present a case of a 56-year-old male who underwent the latter for an incidentally discovered 3 cm retro-rectal mass.
Surgical Technique: Four port sites configured transversely across the abdomen were used to triangulate on the pelvis. After docking of the robot and insertion of the instruments under direct visualization, dissection was carried on to into the pelvis and the rectosigmoid junction identified. The peritoneum was incised along the right lateral aspect of the rectum and the sacral promontory exposed. The pre-sacral space was then entered and dissection continued to the pelvic mass. The mass was circumferentially dissected from the surrounding, liberated from the pelvis, and removed through the 12mm trocar site. The peritoneal defect was closed via a self-locking absorbable suture.
Results: The patient was successfully treated with robot-assisted trans-abdominal excision of his retro-rectal mass and was discharged home on post-operative day one. This surgical technique proved to be both safe and feasible.
Conclusion: Continued advancement of robot-assisted surgery may show that a trans-abdominal approach to resection of pre-sacral tumors is superior to the perineal approach.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 91869
Program Number: V198
Presentation Session: Video Loop Day 1
Presentation Type: VideoLoop