Korean J Obstet Gynecol.  2012 Aug;55(8):601-605. 10.5468/KJOG.2012.55.8.601.

A case of single-site-incisional extraperitoneal laparoscopic staging surgery in locally advanced cervical cancer

• Lee SJ
• Byun SW
• Choi M
• Hwang SJ
• Park ST
• Lee KH
• Park JS

• KMID: 2078113
• DOI: http://doi.org/10.5468/KJOG.2012.55.8.601

Abstract

Para-aortic and common iliac node metastases are high risk factors of recurrence after chemoradiation in advanced cervical cancer. We aim to present the first Korean case of extraperitoneal laparoscopic lymphadenectomy by single site incision in the surgical staging of patients with bulky stage IIB2 cervical cancer. A 51-year-old woman with stage IIB2 cervical cancer were surgically staged by retroperitoneal approach. The operating time was 115 minutes and there were no intraoperative complications. Thirty five nodes were collected and none of which were negative for metastasis. Single site incision extraperitoneal laparoscopic common iliac and para-aortic lymphadenectomy is a safe and feasible procedure to identify the risk of systemic metastasis and to assess the need for extended-field radiation and/or chemotherapy in patients with advanced cervical cancer. The advantages of this surgery are comparable harvested nodes and operating time as well as cosmetic effect.

Keyword

Uterine cervical neoplasm; Neoplasm staging; Retroperitoneal space

MeSH Terms

Cosmetics
Female
Humans
Intraoperative Complications
Lymph Node Excision
Middle Aged
Neoplasm Metastasis
Neoplasm Staging
Recurrence
Retroperitoneal Space
Risk Factors
Uterine Cervical Neoplasms
Cosmetics

Figure

• 

  Fig. 1 Outside view in single incisional laparoscopic retroperitoneal staging surgery. (A) Incisional site (dotted line) are drawed from 3 cm mediosuperior to antereosperior iliac spine. (B) Subcutaneous and fascial dissection by instrument and hand. (C) Inserted self-retractor and transumblical trocar. (D) Overview of single port laparoscopic operating field.

• 

  Fig. 2 Inner body view. (A) Inserted self-retractor (arrow head) under transumblical laparoscope. (B) Removing left paraaortic lymph nodes. (C) Dissecting right paraaortic lymph nodes. (D) Overview after left and right paraaortic nodes dissection. AO, aorta; LCA, left common artery; RCA, right common artery; LCV, left common vein; LOV, left ovarian vein; IMA, inferior mesenteric artery; LU, left ureter; RU, right ureter.

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