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A Combined One-Staged Robot-Assisted Sacral Chordoma Resection.
Melina Castiglione1, Carlo Conti1, Domenico Frondizi1
1Department of Neuroscience, Neurosurgery, Saint Maria University of Terni, Terni, Italy.
World Neurosurgery
|June 20, 2020
Summary
Robot-assisted surgery safely removed a sacral chordoma in a patient with severe pain and bowel dysfunction. This minimally invasive approach led to pain relief and functional recovery, demonstrating its potential for complex oncologic procedures.
Area of Science:
- Oncologic surgery
- Minimally invasive surgery
- Robotic surgery
Background:
- Robotic surgery is an advanced minimally invasive technology increasingly utilized in urologic oncology and other surgical specialties.
- It offers potential benefits for high-risk procedures by minimizing complications.
- A combined 1-staged robot-assisted multidisciplinary surgery with intraoperative neurophysiological monitoring is explored for sacral chordoma removal.
Observation:
- A 64-year-old woman presented with drug-resistant low back and abdominal pain, later developing constipation.
- Imaging revealed a large sacral mass causing sacral destruction and rectal compression.
- The tumor was surgically removed using a combined anterior laparoscopic robot-assisted and posterior open approach with continuous neurophysiological monitoring.
Findings:
- Histological diagnosis confirmed the sacral mass as a chordoma.
- The patient experienced significant pain relief post-surgery.
- Complete recovery of bowel function was observed with a favorable 11-month follow-up.
Implications:
- Combined robot-assisted surgery with neurophysiological monitoring is a promising treatment for selected sacral chordoma cases.
- Robotic technology, when used by experienced teams, can enhance surgical outcomes and reduce complications.
- Longer follow-up studies are required to assess long-term recurrence rates and survival outcomes.
