Robotic abdominal resection of tailgut cysts – A technical note with step‐by‐step description

Abstract

Aim Here, we describe a step‐by‐step standardized technique for tailgut cyst resection using a single‐docking robotic approach. Method Each step of the technique is illustrated using a composite collection of four operative patient videos to demonstrate the advantages and feasibility of this technique. The robot platform utilised is Da Vinci Xi. Results Five female patients have undergone this operation in our unit. The size of tumours ranged from 12 to 45 mm. Median operating time was 100 min (range 90–150). Mean blood loss in all the patients was less than 50 ml. There were no major intraoperative complications. One patient had a postoperative presacral collection which required radiological drainage. Length of stay in all patients was one day. Conclusions This technique using a single‐docking robotic approach appears safe and feasible. The robotic approach results in improved dexterity and more accurate dissection, better retraction and excellent vision which improves the ease of operating in the pelvis. Therefore, this approach can be replicated for use in a wide variety of patients with tailgut cysts.

Analysis of the clinicopathological features of tailgut cyst with emphasis on the development of neoplastic lesions

“…The existence of a multilocular cyst, which is usually filled with mucoid content, is a useful diagnostic criterion for tailgut cyst (1). The management of tailgut cyst comprises complete surgical resection-either open, laparoscopic or robot-assisted surgery (1,(6)(7)(8). The appropriate surgical approach depends on the location and size of the lesion, and its relation with the surrounding structures (1,6,7).…”

Trans‐abdominal single‐incision robotic surgery with the da Vinci SP® surgical system for 8 cases of retrorectal tumour

“…To our knowledge, this study is the first report on the surgical excision of retrorectal tumours using single-incision robotic surgery with dVSP, which demonstrated its feasibility with favourable peri- were consistent with previous studies; however, the absence of intraoperative complications, specifically rectal injury, was noteworthy. 8,11,12 The selection of the surgical approach is conventionally dictated by the size and extent of the retrorectal tumour. Tumours extending beyond the S3 vertebral body or necessitating en bloc resection of adjacent organs warrant the adoption of an anterior or combined approach.…”

“…[13][14][15] There have been a few case series for robotic resection for retrorectal tumours especially in cases of tailgut cyst. [7][8][9][10] Rompen et al reported five cases of robotic resection for tailgut cysts situated at the S3-S5 level, posterior to the rectum, using the da Vinci Si system. They demonstrated the feasibility and safety of robotic resection, particularly emphasising the suitability of the robotic trans-abdominal approach when the cysts are located on the levator ani muscle.…”

“…However, these studies employed earlier models of the da Vinci surgical system, such as da Vinci Si and da Vinci Xi. [7][8][9][10] To the best of our knowledge, there have been no reports on the surgical excision of retrorectal tumours by single-incision robotic surgery using the da Vinci SP (dVSP) surgical system (Intuitive Surgical, Sunnyvale, CA, USA). This study aimed to evaluate the feasibility of transabdominal single-incision robotic surgery using a dVSP surgical system for retrorectal tumours.…”

“…Specifically, a few published case series have explored the utilization of the robotic approach for retrorectal tumours. However, these studies employed earlier models of the da Vinci surgical system, such as da Vinci Si and da Vinci Xi 7–10 …”