J Gynecol Oncol.  2015 Jul;26(3):222-226. 10.3802/jgo.2015.26.3.222.

Robotic high para-aortic lymph node dissection with high port placement using same port for pelvic surgery in gynecologic cancer patients

Affiliations
  • 1Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. tj28.kim@gmail.com
  • 2Department of Obstetrics and Gynecology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea.

Abstract


OBJECTIVE
This study reports our initial experience of robotic high para-aortic lymph node dissection (PALND) with high port placement using same port for pelvic surgery in cervical and endometrial cancer patients.
METHODS
Between July 2013 and January 2014, we performed robotic high PALND up to the left renal vein during staging surgeries. With high port placement and same port usage for pelvic surgery, high PALND was successfully performed without repositioning the robotic column. All data were registered consecutively and analyzed retrospectively.
RESULTS
All patients successfully underwent robotic high PALND, followed by hysterectomy and pelvic lymph node dissection. Median age was 45 years (range, 39 to 51 years) and median body mass index was 22 kg/m2 (range, 19.3 to 23.1 kg/m2). Median operative time for right PALND and left PALND was 37 minutes (range, 22 to 65 minutes) and 44 minutes (range, 36 to 50 minutes), respectively. Median number of right and left para-aortic lymph node by pathologic report was 12 (range, 8 to 15) and 13 (range, 5 to 26).
CONCLUSION
With high port placement and one assistant port, robotic high PALND with the same port used in pelvic surgery is feasible to non-obese patients.

Keyword

Endometrial Neoplasms; Intraoperative Complications; Lymph Node Excision; Robotics; Surgical Instruments; Uterine Cervical Neoplasms

MeSH Terms

Adult
Endometrial Neoplasms/*surgery
Feasibility Studies
Female
Humans
Intraoperative Complications/etiology
Laparoscopy/instrumentation/*methods
Lymph Node Excision/instrumentation/*methods
Lymphatic Metastasis
Middle Aged
Operative Time
Retrospective Studies
Robotic Surgical Procedures/instrumentation/*methods
Surgical Instruments
Uterine Cervical Neoplasms/*surgery

Figure

  • Fig. 1 The port placement (intraoperative and postoperative view). (A) The cephalad part is above the assistant port and the caudal part is below the umbilicus. (B) Left side is the cephalad part and right side is the caudal part.

  • Fig. 2 Intraoperative view after completing left side para-aortic lymph node dissection to inferior mesenteric artery level. Inferior mesenteric artery originating from aorta is seen just above the suction.

  • Fig. 3 Intraoperative view after completing left side para-aortic lymph node dissection to left renal vein level. Left renal vein is seen at left side to the suction.


Cited by  1 articles

Robotic lower pelvic port placement for optimal upper paraaortic lymph node dissection
Jiheum Paek, Elizabeth Kang, Peter C. Lim
J Gynecol Oncol. 2018;29(6):.    doi: 10.3802/jgo.2018.29.e87.


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