Robot-assisted excision of a huge pararectal dermoid cyst via a totally transabdominal route

Herein is reported the case of a 17-year-old adolescent with a huge cystic mass located between the vagina and the rectum, with extension into the gluteal region. The lesion caused compression and dislocation of the bladder, uterus, adnexae, and rectum. The patient underwent robot-assisted surgical excision of the mass via a totally transabdominal route. Postoperative recovery was uneventful, with excellent functional and cosmetic results. To our knowledge, this is the first case of a huge pelvic pararectal cyst reaching up to the gluteus and excised via a totally transabdominal approach with the aid of robotic assistance. Robot-assisted surgery seems to be appropriate for therapeutic management of huge pararectal tumors, the major advantages being minimum damage to contiguous structures, rapid postoperative recovery, and excellent cosmetic results.