Robot-assisted thoracoscopic surgery for large apical schwannoma in an obese patient

Abstract

Background Neural tumors at the thoracic apex require a careful surgical technique because of the presence of vascular and neural structures and minimally invasive surgery can be challenging for these tumors, especially large tumor in obese patients. We report a case of a large apical schwannoma that treated with RATS in an obese patient. Case presentation An obese, diabetic, 36-year-old obese man with a body mass index of 34.7 presented with a 5.0-cm mediastinal mass in the left thoracic apex diagnosed via chest computed tomography. The magnetic resonance images suggested a schwannoma. Surgery was scheduled after glycemic control. Robot-assisted thoracoscopic surgery (RATS) was performed with in the right lateral position, and tumor was dissected from the surrounding tissue without severe nerve injury using bipolar forceps. The pathological diagnosis was benign schwannoma. The patient had an uneventful clinical course and was discharged on postoperative day 3. Conclusion RATS may be a useful approach in the narrow space of the thoracic cavity in obese patients.