Successful Robotic Excision of a 6 cm Presacral Mass with Same Day Discharge

Clinical case: presacral tumors are rare and often present surgical challenges due to their proximity to critical pelvic structures. Traditional approaches such as the Kraske or perineal incision carry significant morbidity, prolonged recovery, and risk of complications. Robotic platforms offer enhanced visualization and dexterity, potentially reducing operative morbidity. We report a case of successful robotic excision of a 6 cm presacral mass with sameday discharge.

Methods

A patient presented with pelvic pain and was found on imaging to have a 6 cm presacral mass. Using a robotic platform, the mass was excised via four 8 mm incisions. Care was taken to maintain an intact specimen during meticulous dissection along the avascular planes. Postoperatively, the patient was monitored in the recovery unit and discharged later the same day.

Results

The mass was successfully excised intact without intraoperative complications. Estimated blood loss was minimal, and operative time was within expected limits for complex pelvic procedures. The patient was ambulating, tolerating oral intake, and discharged on the day of surgery. Final pathology revealed a benign tailgut cyst.

Conclusions

Robotic excision of presacral tumors can be performed safely and effectively with minimal morbidity. This approach avoids the complications associated with traditional Kraske or perineal access while enabling intact resection and expedited recovery. Sameday discharge further underscores the potential of robotic platforms to transform management of challenging pelvic pathology.