Thorascopic resection of an apical paraspinal schwannoma using the Da Vinci surgical system Journal Article

Authors: Finley, D.; Sherman, J. H.; Avila, E.; Bilsky, M.
Article Title: Thorascopic resection of an apical paraspinal schwannoma using the Da Vinci surgical system
Abstract: Background Posterior mediastinal neurogenic tumors have traditionally been resected via an open posterolateral thoracotomy. Video-assisted thorascopic surgery has emerged as an alternative technique allowing for improved morbidity with decreased blood loss, less postoperative pain, and a shorter recovery period, among others. The da Vinci surgical system, as first described for urologic procedures, has recently been reported for lung lobectomy. This technique provides the advantages of instrumentation with 6 degrees of freedom, stable operating arms, and improved visualization with the three-dimensional high-definition camera. Methods We describe the technique for thorascopic resection of an apical paraspinal schwannoma of the T1 nerve root with the da Vinci surgical system. This technique used a specialized intraoperative neuromonitoring probe for free-running electromyography (EMG) and triggered EMG. Results We demonstrate successful resection of a posterior paraspinal schwannoma with the da Vinci surgical system while preserving neurologic function. The patient displayed stable intraoperative monitoring of the T1 nerve root and full intrinsic hand strength postoperatively. Conclusion The technique described in this article introduces robotic system accuracy and precludes the need for an open thoracotomy. In addition, this approach demonstrates the ability of the da Vinci surgical system to safely dissect tumors from their neural attachments and is applicable to other such lesions of similar size and location. © 2014 Georg Thieme Verlag KG Stuttgart New York.
Keywords: schwannoma; apical mediastinum; da vinci robot; thorascopic
Journal Title: Journal of Neurological Surgery. Part A: Central European Neurosurgery
Volume: 75
Issue: 1
ISSN: 2193-6315
Publisher: Thieme Publishing  
Date Published: 2014-01-01
Start Page: 58
End Page: 63
Language: English
DOI: 10.1055/s-0033-1345687
PROVIDER: scopus
PUBMED: 23884620
Notes: Export Date: 3 March 2014 -- Source: Scopus
Citation Impact
MSK Authors
  1. Mark H Bilsky
    245 Bilsky
  2. David John Finley
    40 Finley
  3. Edward Kenneth Avila
    24 Avila