Anterior robotic approach in en-bloc sacrectomy: a preliminary experience

  • Giacomo Corrado
  • Carmine Zoccali
  • Nicola Salducca
  • Andrea Oddi
  • Enrico Vizza
  • Roberto Biagini
Original Article
  • 9 Downloads

Abstract

En-bloc sacrectomy is a highly demanding surgical procedure necessary to obtain wide margin in sacral tumor. The double approach, anterior and posterior approach, is usually preferred for tumors extending proximally to S3 level where iliac internal vessels are at a higher risk for damage during posterior surgery. It can be justified also in selected cases to decrease the risk of posterior approach as in local recurrence or in patients who already underwent laparotomy. Our intent was to apply robotic-assisted techniques for performing anterior preparatory approach for sacrectomy surgery. Between December 2010 and December 2014, three cases of sacrectomies were performed in a previous robotic-assisted preparatory approach to separate the rectum from the tumor. Dissections were successfully performed in all cases close to the pelvic floor. The surgeon was able to position a Gore-Tex spacer between the anterior tumor surface and the rectum in all cases. The anterior dissections were performed with a perfect control of bleeding. No complications related to the anterior approach were reported. Robot-assisted surgery can be considered a valid and minimally invasive technique which allows a safe anterior dissection of the pelvic structures dividing tumors from surrounding tissues. It allows to place a spacer to protect organs during posterior sacral resection performed on the same day or at a later time. Further experiences are advocated to evaluate its efficiency in sacral tumors of greater size.

Keywords

En-bloc sacrectomy Robot-assisted surgery Minimally invasive surgery 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest; no funding was received for the present study.

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Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Gynecologic Oncology Unit, Department of Health of Women and ChildrenCatholic University of Sacred HeartRomeItaly
  2. 2.Orthopedic Oncology Unit, Department of Experimental Clinical Oncology“Regina Elena” National Cancer InstituteRomeItaly
  3. 3.Liver and Pancreatic Surgical Unit, Department of Experimental Clinical Oncology“Regina Elena” National Cancer InstituteRomeItaly
  4. 4.Gynecologic Oncology Unit, Department of Experimental Clinical Oncology“Regina Elena” National Cancer InstituteRomeItaly

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