Total Laparoscopic Resection by Retroperitoneal Approach Using Virtual Navigation: Two Case Reports of Primary Retroperitoneal Schwannoma

Background: We report two rare cases of retroperitoneal schwannoma completely resected by laparoscopic retroperitoneal approach aided by virtual navigation. Case presentation: These two case reports are of a 60‐year‐old man and a 40‐year‐old man with asymptomatic retroperitoneal schwannoma. In both cases, the tumors were located in the right renal hilum and were close to the duodenum, right ureter, and inferior vena cava. Simulation using three-dimensional images was performed before surgery, and a retroperitoneal approach was performed to secure a wide surgical field. During the operation, we confirmed the location of the main feeder and the relationship between the tumor and organs with those shown on the three-dimensional images and performed total laparoscopic resection. Conclusion: The retroperitoneal approach provides operative safety. Preoperative simulation and intraoperative navigation with three-dimensional images are useful methods to enhance the surgeon’s understanding of a patient’s specific anatomy and are especially effective when resecting a retroperitoneal tumor that is located in an anatomically deep and complex location.