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Robotic-Assisted Excision of Retroperitoneal Mass

Alexander L Marinica, DO, Lindsay A Nelson, DO, Fazal Din Moghul, DO, Abubaker Ali, MD, FACS. Detroit Medical Center – Sinai Grace Hospital

This is a case presentation of the excision of a retroperitoneal mass using the robotic platform. The patient is a 61-year-old male who presented with left lower quadrant abdominal pain for two months, and associated weight loss, nausea, vomiting, and constipation. Of note, he was in a car accident approximately seven years prior, and was not aware he had a left-side retroperitoneal cyst before that hospital admission. Abdominal CT imaging revealed a large isolated cystic mass, measuring 8.7×8.1×7.8cm, representing a cyst. Robotic excision was performed via a four-port, transabdominal, transperitoneal, laparoscopic approach. The procedure was complicated by accidental thermal injury to the left ureter. The Urology service was consulted intraoperatively, performing a cystogram and ureteroscopy with no occult injury noted. A stent was placed at this time, to guard against development of a complication from a delayed thermal injury. Final pathology showed benign, non-epithelial cystic structure that was fibromembranous with chronic inflammation and congestion, negative for malignancy. The patient was found stable for discharge on post-operative day one. The stent was left in place for three months and removed by the Urologist in the office. The patient was seen three months post-op, his pain controlled and having no further issues. Although this case was complicated by an accidental ureter injury, we demonstrate a method by which to recognize and address this complication definitively. This case is a demonstration of the safe excision of a retroperitoneal mass using the robotic platform. 


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 93237

Program Number: V246

Presentation Session: Video Loop Day 2

Presentation Type: VideoLoop

68

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