Novel Two-Stage Open Spine and Robotic Thoracic Approach to Resection of a Mediastinal Tumor

Posterior mediastinal dumbbell tumors are rare, and dumbbell tumors of nonneurogenic origin are even more infrequent. Here we discuss a novel surgical approach to resection. A 60-year-old man presented with several years of bilateral lower extremity weakness. Axial imaging demonstrated a large T3 paraspinal tumor with invasion into the spinal canal and left thorax. Resection was completed in a multidisciplinary staged approach: a partial mass resection and posterior spine decompression and fusion, followed by robotic-assisted left thoracoscopic extraspinal tumor excision. Staged robotic-assisted resection with this type of tumor has never been attempted.