title: Robotic excision of a pre-coccygeal nerve root tumor.
abstract: Pre-coccygeal ganglioneuroma is a rare clinical entity that presents incidentally or with non-specific symptoms. We present a case of a 25 year old housewife who was incidentally diagnosed with pre-coccygeal ganglioneuroma while getting investigated for primary infertility. The patient had no specific complaints except for irregular menstruation which had started 8 months back. Magnetic resonance imaging (MRI) was suggestive of a presacral and pre-coccygeal lesion. Resection of the tumor was done through the anterior approach using the da Vinci Si robotic system. Two robotic arms and one assistant port were used to completely excise the tumor. Robotic excision of such a tumor mass located at a relatively inaccessible area allows enhanced precision and 3-dimentional (3D) view avoiding damage to important surrounding structures.
authors.affiliation: Department of Bariatric and GI (laparoscopic and robotic) Surgery, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Four Bungalows Andheri (West), Mumbai, Maharashtra, India.
authors.forename: Jaydeep H
authors.initials: JH
authors.lastname: Palep
authors.affiliation: Department of General and Bariatric Surgery, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Four Bungalows Andheri (West), Mumbai, Maharashtra, India.
authors.forename: Sheetal
authors.initials: S
authors.lastname: Mistry
authors.affiliation: Department of Neurosurgery, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Four Bungalows Andheri (West), Mumbai, Maharashtra, India.
authors.forename: Abhaya
authors.initials: A
authors.lastname: Kumar
authors.affiliation: Department of Neuroradiology, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Four Bungalows Andheri (West), Mumbai, Maharashtra, India.
authors.forename: Mihir
authors.initials: M
authors.lastname: Munshi
authors.affiliation: Department of Anesthesia, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Four Bungalows Andheri (West), Mumbai, Maharashtra, India.
authors.forename: Meenakshi
authors.initials: M
authors.lastname: Puranik
authors.affiliation: Department of Robotic Surgery, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Four Bungalows Andheri (West), Mumbai, Maharashtra, India.
authors.forename: Abhinav
authors.initials: A
authors.lastname: Pednekar
keywords: Broad ligament; da Vinci surgery; pre-coccygeal ganglioneuroma; retro-rectal space; robotic surgery