Shanghai General Hospital | Multidisciplinary Collaboration Successfully Removes Giant Presacral Tumor Using Robotic Minimally Invasive Surgery

https://mp.weixin.qq.com/s/hR5bv47zf_NYBYBRSgizgA

Recently, the Spine Surgery Department (South Campus) of Shanghai General Hospital, in collaboration with the Urology Department and supported by the Anesthesiology Department and the Operating Room Nursing Team, successfully removed a 10 cm giant tumor located in the retroperitoneal presacral region of a patient.

The patient, a young male, initially sought medical consultation with Professor Song Dianwen, Director of the Spine Surgery Department (South Campus) at Shanghai General Hospital. MRI imaging revealed a massive tumor in the patient's pelvic region, specifically in the presacral retroperitoneal area, with a maximum diameter exceeding 10 cm. In addition to its large size, the tumor's location posed significant challenges: it was closely adjacent to critical structures such as the sacral nerves, iliac arteries, iliac veins, and ureters. While surgical removal carried substantial risks, leaving the tumor untreated would pose a "ticking time bomb" within the patient, potentially leading to severe consequences and increasingly complex treatment. Professor Song Dianwen's team decided to tackle the challenge head-on and scheduled surgery promptly.

The critical challenges of this surgery included precise localization and complete removal of the tumor while minimizing damage to surrounding vital anatomical structures. Tumors in this region are often referred to as "tumors of the no-man’s-land," and in this case, the tumor had invaded parts of the pelvis, involving the spine, urinary system, and surrounding nerves and blood vessels. Even the slightest error during surgery could result in severe complications or even life-threatening outcomes.

To address these challenges, Professor Song Dianwen reached out to his Naval Medical University classmate, Dr. Xu Chuanliang, Executive Director of the Urology Center (South Campus) at Shanghai General Hospital. The two teams had previously collaborated successfully on a similarly complex case involving a tumor in the anterior lumbar spine region. After a thorough discussion of the case’s characteristics and surgical strategies, the multidisciplinary team decided to utilize a robotic surgical system to perform the procedure.

On the day of the surgery, Professor Song Dianwen led a team comprising Chief Physician Yin Huabin, Dr. Wang Gangyang, and Dr. Huang Weibo, collaborating with Dr. Xu Chuanliang and Dr. Hua Meimian’s team. The operation lasted eight hours. Professor Song’s team focused on managing the spinal and pelvic tumor resection and separation, while Dr. Xu’s team handled the retroperitoneal tumor dissection and repair. With the aid of the robotic surgical system, which provided high-definition 3D visualization and micron-level precision, the team successfully avoided damage to critical surrounding structures and achieved complete tumor removal while preserving maximum functionality. The patient recovered well postoperatively and was recently discharged.

This successful surgery represents a significant breakthrough for the South Campus of Shanghai General Hospital in performing highly complex operations. It also marks an important advancement in the application of robotic surgical technology in treating challenging cases. The smooth execution of this surgery and the patient’s excellent recovery provide valuable experience and new approaches for managing similar complex cases in the future. Shanghai General Hospital’s South Campus remains committed to patient-centered care, advancing the integration of technology and clinical practice, and continuously improving the diagnosis and treatment of difficult and critical cases to bring hope to more patients.

Contributor: Huang Weibo, Orthopedics Center
Editor: Hu Yang and Cai Shishi，Public Relations and Spiritual Civilization Department