VM09 - Robotic Resection of Presacral Tumor

Purpose/Background: Presacral tumors are rare​. Traditionally, these tumors have been excised using an open abdominal and/or perineal surgical approach; however, the use minimally invasive approaches have increased​​. The following video shows a robotic resection of a large presacral tumor in a 37-year-old male patient.

Methods/Interventions: The patient presented with abdominal pain and worsening constipation. A mass was felt in the rectum during digital rectal exam. Computed tomography (CT) revealed a 14.8 x 10.0 x 17.5 cm mass in the pre-sacral space and appeared to be a benign cyst. We decided to approach this tumor robotically due to the increased freedom of movement, 3D magnification, and the increased accessibility to small working spaces such as the pelvis. Robotic surgery is also associated with decreased blood loss and shorter hospitalization times​. The mass was successfully resected using the Da Vinci Xi system.

Results/Outcomes: Pathology revealed findings consistent with a tailgut cyst. The patient remains disease-free at most recent follow-up.​

Conclusion/Discussion: Robotic resection is a safe and effective way to remove benign cystic presacral tumors.