493 Robotic Organ sparing Exeresis of a Large Pelvic Mass in a Male Patient- Dr Alessandro Marquis

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Published
This video is being presented at the Humans at the Cutting Edge of Robotic Surgery Symposium 2024, Jaipur, India. It was produced by Dr Alessandro Marquis, Division of Urology, Department of Surgical Sciences, AOU Città della Salute e della Scienza at Molinette Hospital and University of Turin School of Medicine, Italy
Abstract:
Robotic Organ-sparing Exeresis of a Large Pelvic Mass in a Male Patient
Authors
Alessandro Marquis, Marco Oderda, Paolo Gontero
Affiliations
Division of Urology, Department of Surgical Sciences, AOU Città della Salute e della Scienza at Molinette
Hospital and University of Turin School of Medicine
Introduction
Due to the abnormal pelvic anatomy and the higher risk of complications, the exeresis of large pelvic masses
is mainly performed with an open approach. Our video aims to show the feasibility of the robotic approach in
this procedure.
Methods
An asymptomatic 52 y.o. male had an occasional US finding of a pelvic mass in August 2021. The following
multiparametric MRI revealed a 9.0x8.6cm pelvic mass located in the anterior portion of the mesorectum,
indissociable from the left posterolateral portion of the bladder and prostate, with both seminal vesicles right
shifted. At the biopsy, a mesenchymal tumor with low mitotic and proliferative index was found. The FDG
PET-CT scan was negative for distant metastases. The patient was initially treated with chemo and radiation
therapy in a different hospital with only a partial downsize of the mass (7.5x7.2cm). The patient presented to
our attention asking for robotic excision of the mass.
Results
The procedure was completed in June 2022. No perioperative complications were recorded. Operative time
was 250min. Estimated blood losses were 300mL. The urinary catheter was removed on POD-4 with full
recovery of continence. The patient was discharged on POD-7. The final pathology revealed a solitary
fibrous tumor, a rare mesenchymal tumor with a non-negligible potential for distal metastases. The patient is
under oncological follow-up, currently without evidence of disease.
Conclusions
When appropriate surgical skills are available, the minimally invasive robotic approach can be a feasible
option for the exeresis of large pelvic masses with preservation of pelvic organs.

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Category
Urology
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