Removal of pelvic schwannoma using a retroperitoneoscopic and open double approach: description of an effective novel technique.

Introduction: Schwannomas are rare tumors and are exceptionally retroperitoneal. In the event of clinical signs or uncertainty in the diagnosis, their removal is justified. A risk of neoplastic transformation exists.

Patients And Methods: Three patients had a retroperitoneal schwannoma located next to or under the sacral promontory. A double approach using an initial retroperitoneoscopy and an iliac abdominal incision had been decided preoperatively. This approach has not been described previously in the medical literature.

Results: The double approach enabled the complete removal of tumors in all patients. The iliac incision, described within, enabled the removal of the tumors despite major attachments and difficulties in exposure, due to the tumors' distal situations.

Conclusion: A double approach by retroperitoneoscopy and laparotomy can enable removal of difficult low-seated retroperitoneal schwannomas without increasing intraoperative risk or perioperative morbidity.