Robot-assisted ventral sacral Tarlov cystectomy; A case report

Area of Science:

• Neurosurgery
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Symptomatic Tarlov cysts (TCs) are rare, often affecting sacral nerve roots and causing debilitating pain.
• Ventral sacral TCs in the pelvic retroperitoneal space are exceptionally rare, with limited management guidelines.
• Traditional surgical options for TCs can be invasive and may not offer definitive solutions.

Purpose of the Study:

• To evaluate the efficacy and safety of robot-assisted resection for ventral sacral Tarlov cysts.
• To present a case study of a patient with a large retroperitoneal sacral TC managed robotically.

Main Methods:

• A 39-year-old female patient with a 4-year history of low back and pelvic pain underwent robotic-assisted anterior surgical resection of a large retroperitoneal S3 Tarlov cyst.
• Magnetic Resonance Imaging (MRI) was used for diagnosis and surgical planning.
• The robot-assisted approach facilitated excellent visualization and maneuverability in the retroperitoneal space.

Main Results:

• The robot-assisted resection successfully removed the sacral Tarlov cyst.
• The patient experienced significant postoperative pain relief.
• The patient regained the ability to perform daily activities and returned to work.

Conclusions:

• Robot-assisted resection is a safe and effective minimally invasive surgical option for sacral nerve root Tarlov cysts located anteriorly in the pelvic retroperitoneal space.
• Robotic systems enhance visualization and instrument control for complex pelvic surgeries.
• This technique offers a promising alternative for managing symptomatic TCs in this challenging anatomical location.