Cendejas-Gómez JJ, Sandoval BH, Almeida MR, Ortega GME, Esqueda SD, Villeda SCI

Language: Spanish
References: 16
Page: 104-108
PDF size: 254.83 Kb.

ABSTRACT

Introduction: Testicular cancer is a common pathology among men between 20 and 35 years old. After first-line treatment for retroperitoneal disease with bleomycin, etoposide, and cisplatin (BEP), only 6-10% of the residual masses of non-seminomatous tumors will have active cancer. Robot-assisted laparoscopic resection of post-chemotherapy residual masses is a feasible option. Case report: 17-year-old man with a history of a mixed left testicular tumor with a 3.1 × 3.7 × 5.3 cm retroperitoneal residual mass after chemotherapy seen on PET/CT. The patient underwent tumor resection with a robot-assisted laparoscopic approach. A total of five ports were placed in the abdomen and then the four robotic arms were docked. Initially, the Told line was incised, and the descending colon was mobilized medially. The left ureter and the gonadal vein were identified. Then, the residual mass was identified in the paraaortic and infrarenal area. Then, the dissection of the pre-aortic and paraaortic ganglionar packs was performed, taking the left ureter as the lateral edge of the dissection and the renal vein as the upper limit. Superficial sympathetic fibers and hypogastric plexus were preserved. The surgical time was 240 minutes and the bleeding was 150 mL. Postoperative course was uneventful, with early resumption of daily activities and with very good aesthetic result. Conclusion: The robot-assisted laparoscopic approach in this case, offered an adequate oncological, functional and aesthetic result, avoiding the morbidity associated with open surgery.

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