One-stage robotic resection for thoracic dumbbell tumor without repositioning

Masaki Hashimoto, Fumihiro Arizumi, Aya Yamamoto, Kazuki Kusuyama, Akifumi Nakamura, Toshiya Tachibana, Seiki Hasegawa
Annals of Thoracic Surgery 2021 January 19
A 67-year-old female presented with a thoracic dumbbell-shaped tumor at the left T3-4 level. One-staged surgical resection via the spinal and robotic-assisted thoracic approach without repositioning was planned. The patient was placed in the prone position under general anesthesia. First, the tumor was dissected from the dura after T3 left hemilaminectomy and T3/4 left facetectomy. Then, posterior spinal fixation was performed. Second, three ports were placed in her left thoracic cavity without repositioning and the tumor was resected via robotic-assisted thoracic approach. The tumor was a schwannoma without malignant potential. Convalescence was uneventful and she was discharged 14 days postoperatively. A dumbbell-shaped thoracic tumor is relatively rare and surgical resection usually is considered due to the possibility of neurologic symptoms. Surgical strategies for dumbbell-shaped tumor depend on its location and size (1). A combined spinal and video-assisted thoracoscopic surgery (VATS) approach is a standard procedure for resection of a dumbbell-shaped tumor. This approach allows for visualization of the tumor and surrounding organs, and also provides for an accurate and safe surgical technique. Recently, a robotic approach has been attempted instead of the VATS approach (2). We report a case with complete resection of a thoracic dumbbell-shaped tumor via a spinal and robotic approach without repositioning.

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