Integrating Robotics into Neurosurgery: Robot-Assisted Surgery for Retroperitoneal Nerve Sheath Tumors. Case Series...

Robotics has gained popularity in abdominal and pelvic oncological surgery, showing advantages such as reduced blood loss and postoperative pain, and shorter hospital stays. Its use has expanded to resect retroperitoneal Nerve Sheath Tumors (NSTs), allowing for minimally invasive excision of larger tumors within a complex anatomic setting. In this study, we present our initial experience with robotic resection of a retroperitoneal NSTs and conduct a systematic review of the literature, with a focus on intraoperative performance and long-term outcomes.

At our institution, 2 patients underwent robot-assisted resection of benign retroperitoneal NSTs. Intraoperative neuromonitoring was used to ensure safe and complete tumor excision. The procedures were completed with a mean operative time of 98 minutes and a blood loss of 100 mL. A systematic review was then conducted, identifying 62 additional cases of retroperitoneal NSTs treated with robotic surgery, to assess its efficacy and clinical outcomes.

Robotic-assisted surgery has been performed on 64 cases of retroperitoneal NSTs. The mean surgical time was 1.95 hours (range: 0.27-6.28 hours), with an average blood loss of 57.03 mL (range: 10-600 mL). After surgery, temporary neurological impairments occurred in 12.7% of cases, while persistent neurological deficits were observed in 5.4% of patients. Average postoperative hospital stay was 3.39 days (range: 1-9 days).

Robotic resection of retroperitoneal NSTs has shown potential advantages, including reduced blood loss, shorter operative time, and decreased hospital stay. However, the high initial costs and inherent learning curve remain significant barriers to its widespread adoption in routine clinical practice.