Addison, Poppy

Abstract Background:Presacral tumors are a rare entity typically treated with an open surgical approach. A limited number of minimally invasive resections have been described. Aim of the study was to evaluate the safety and efficacy of robotic resection of presacral tumors. Methods: This was a retrospective single system analysis, conducted at a quaternary referral academic healthcare system, and included all patients who underwent a robotic excision of a presacral tumor between 2015 and 2023. Outcomes of interest were operative time, estimated blood loss, complications, length of stay, margin status, and recurrence rates. Results: Sixteen patients (11 females, 5 males) were included. Median age of the cohort was 51 years (range 25-69). Median operative time was 197 minutes (range 98-802). Median estimated blood loss was 40 ml, ranging from 0 to 1800 ml, with one patient experiencing conversion to open surgery after uncontrolled hemorrhage. Urinary retention was the only post-operative complication that occurred in 3 patients (19%) and was solved within 30 days in all cases. Median length of stay was one day (range 1-6). Median follow-up was 6.7 months (range 1-110). All tumors were excised with appropriate margins, but one benign and one malignant tumor recurred (12.5%). Ten tumors were classified as congenital (one was malignant), two were mesenchymal (both malignant), and five were miscellaneous (one malignant). Conclusions:Robotic resection of select presacral pathology is feasible and safe. Further studies must be conducted to determine complication rates, outcomes, and long-term safety profiles.