Laparoscopic and Robotic Surgical Clinic, Athens Medical Centre, Athens, Greece.
Int J Med Robot. 2011 Mar;7(1):55-9. doi: 10.1002/rcs.369. Epub 2011 Jan 24.
Robotic-assisted excision of a pelvic schwannoma is presented.
A 27 year-old female presented with occasional numbness of the right thigh. Imaging studies revealed a large mass adjacent to the right ovary. Robotic surgery with adjunctive electrophysiological monitoring was performed. The mass was adhered to the L4, L5 roots and was displacing the iliac vessels and the ureter. The tumour bulk was decompressed and total excision was facilitated.
Pathology revealed a neoplasm consisting of spindle cells. Immunochemistry revealed S-100(+) and a growth index Ki-67 < 1%. These findings were consistent with the diagnosis of ancient schwannoma. The intraoperative time was comparable to laparoscopy and the patient had an uneventful recovery.
Ancient schwannoma is often diagnosed only when it is large enough to produce symptoms. Robotic surgery with adjunctive electrophysiological monitoring is a safe technique for the removal of large pelvic neurinomas.
介绍了机器人辅助切除骨盆 schwannoma 的方法。
一位 27 岁女性偶尔出现右大腿麻木。影像学检查显示右侧卵巢附近有一个大肿块。采用机器人手术，并辅以电生理监测。肿块与 L4、L5 神经根粘连，并使髂血管和输尿管移位。肿块减压，便于完全切除。
病理显示为梭形细胞瘤。免疫组化显示 S-100(+)，Ki-67 生长指数<1%。这些发现与古老 schwannoma 的诊断一致。术中时间与腹腔镜相当，患者恢复顺利。
只有当 schwannoma 大到足以产生症状时，才能做出明确诊断。机器人手术辅以电生理监测是一种安全的技术，可用于切除大型骨盆神经瘤。
