A novel two-stage open spine and robotic thoracic approach to resection of a mediastinal tumor.

Posterior mediastinal dumbbell tumors are rare and dumbbell tumors of non-neurogenic origin are even more infrequent. Here, we discuss a novel surgical approach to resection. A 60 year old male presented with several years of bilateral lower extremity weakness. Axial imaging demonstrated a large T3 paraspinal tumor with invasion into the spinal canal and left thorax. Resection was completed in a multidisciplinary staged approach; a partial mass resection and posterior spine decompression and fusion, followed by robotic-assisted left thoracoscopic extraspinal tumor excision. To our knowledge, staged robotic assisted resection with this type of tumor has never been attempted.