Laparoscopic-Assisted Resection of a Large Retroperitoneal Tumor

BACKGROUND: Retroperitoneal tumors have traditionally been excised using standard open techniques. When preparing the manuscript we knew of only 1 report, in Japanese, describing the excision of 2 retroperitoneal neurofibromas using a minimally invasive technique. The feasibility of the technique was tested in the removal of a large retroperitoneal neurofibroma. METHODS: Laparoscopic-assisted resection of a large retroperitoneal tumor was offered to a 37-year-old female with a 12x10x9-cm neurofibroma located inferior to the left kidney. The patient was placed on a beanbag in a right lateral decubitus position. Three 5-mm ports were used, and the tumor was mobilized followed by placement of a hand port for completion of dissection and removal of the tumor. RESULTS: The tumor was successfully removed in about 3 hours, and blood loss was <100 cc. The patient developed urinary and bowel dysfunction probably secondary to the effect of the dissection and removal of the tumor on the nearby sacral plexus. CONCLUSIONS: We believe that laparoscopy is a feasible and appropriate technique available to general and laparoscopic surgeons in the management of retroperitoneal tumors, providing excellent visualization and adequate access for proper dissection through small incisions.