Retroperitoneal robot-assisted resection of a lower posterior mediastinal benign schwannoma using a transdiaphragmatic approach

Neurogenic tumors are the most frequent neoplasms of the lower posterior mediastinum. Traditionally, lower posterior mediastinal tumors are excised by video-assisted thoracic surgery. However, the available robotic treatment for the lower posterior mediastinum tumors to date are rare. Herein, we report a case of a right lower posterior mediastinal tumors successfully treated with retroperitoneal robot-assisted surgery using a transdiaphragmatic approach. Patient concerns: A 54-year-old male patient without any symptoms was admitted into our department with a right lower posterior mediastinal paravertebral tumor that was detected during a medical check-up. Diagnosis: A right lower posterior mediastinal paravertebral tumor. Interventions: Retroperitoneal robot-assisted resection using a transdiaphragmatic approach was performed. Outcomes: The patient was treated with retroperitoneal robot-assisted surgery using a transdiaphragmatic approach and remained disease-free throughout a 6-month follow-up. His postoperative course was uneventful. Histopathological examination revealed a benign schwannoma. Conclusion: Our initial experience showed that retroperitoneal robot-assisted resection of a lower posterior mediastinal tumor using a transdiaphragmatic approach is technically feasible and can be considered a potential alternative for either video-assisted thoracic surgery or a thoracotomy.