Higher nodal yield with robot-assisted pelvic lymph node dissection for bladder cancer compared to laparoscopic dissection: implications for more accurate staging

Arora, Amandeep; Pugliesi, Felipe Guimarães; Zugail, Ahmed S.; Moschini, Marco; Pazeto, Cristiano Linck; Macek, Petr; Stabile, Armando; Lanz, Camille; Cathala, Nathalie; Bennamoun, Mostefa; Sánchez-Salas, Rafael; Cathelineau, Xavier

doi:10.1080/2090598x.2020.1824570

Cited by 5 publications

(3 citation statements)

References 32 publications

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“…Robotic extended PLND has a higher lymph node yield than laparoscopic extended PLND. Consequently, the robot-assisted method led to more accurate staging after RC and PLND [ 38 ]. This is likely attributable to the higher probability of adequate dissection in robotic extended PLND than in laparoscopic extended PLND.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic and Robotic-Assisted Extended Pelvic Lymph Node Dissection for Invasive Bladder Cancer: A Review

Fu¹,

Xu²

2023

Bladder

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Minimally invasive surgical techniques, including laparoscopic and robotic-assisted radical cystectomy (RC), are emerging as the preferred treatment options for invasive bladder cancer. Mounting evidence has demonstrated that laparoscopic and robotic-assisted RC with extended pelvic lymph node dissection (PLND) is a viable alternative for managing invasive bladder cancer. In this review, we summarized recent advances and critically assessed the minimally invasive approaches and risk factors associated with extended PLND in patients undergoing laparoscopic or robotic-assisted RC. The findings indicated that laparoscopic and robotic-assisted PLND, employing either a standard or extended approach, is technically feasible and offers benefits such as minimal invasiveness, superior visualization, reduced blood loss, and expedited recovery. The risk factors involved in the laparoscopic extended PLND are minimal. Clinically, laparoscopic and robotic-assisted extended PLND is significantly advantageous in that it sticks to the principles of open surgery and respects anatomical boundaries. Nevertheless, laparoscopic and robotic-assisted extended PLND is technically challenging and necessitate extended operation time. Furthermore, large-scale, prospective, multicenter trials are warranted to validate the long-term efficacy of laparoscopic and robotic-assisted extended PLND in terms of disease-specific survival.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic and Robotic-Assisted Extended Pelvic Lymph Node Dissection for Invasive Bladder Cancer: A Review

Fu¹,

Xu²

2023

Bladder

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“…30 Robotic-assisted total cystectomy is reported to have more lymph node dissection than laparoscopic surgery, and is considered to have significant advantages. 31…”

Section: Raplnd In Urologic Surgerymentioning

confidence: 99%

“…Indeed, although open surgery is the standard for total bladder cystectomy, it is superior in perioperative complications such as less blood loss, and an increasing number of RAPLND has been reported 30 . Robotic‐assisted total cystectomy is reported to have more lymph node dissection than laparoscopic surgery, and is considered to have significant advantages 31 …”

Section: Review Of the Evidences For Plnd In Each Departmentmentioning

confidence: 99%

Standardization of robot‐assisted pelvic lymph node dissection—Development of a common understanding of regional anatomy and surgical technique based on cross‐disciplinary discussion among colorectal surgery, urology, and gynecology

Takemasa,

Hamabe,

Takenaka

et al. 2024

Asian J Endoscop Surgery

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BackgroundPelvic lymph node dissection is a procedure performed in gastroenterological surgery, urology, and gynecology. However, due to discrepancies in the understanding of pelvic anatomy among these departments, cross‐disciplinary discussions have not been easy. Recently, with the rapid spread of robotic surgery, the importance of visual information in understanding pelvic anatomy has become even more significant. In this project, we attempted to clarify a shared understanding of pelvic anatomy through cross‐disciplinary discussions.MethodFrom May 2020 to November 2021, a total of 11 discussions were held entirely online with 5 colorectal surgery specialists, 4 urologists, and 4 gynecologists. The discussions focused on evidence from each specialty and surgical videos, aiming to create a universally understandable pelvic anatomical illustration.ResultsThe common area of dissection recognized across the three departments was identified as the obturator lymph nodes. A dynamic illustration of pelvic anatomy was created. In addition to a bird's‐eye view of the pelvis, a pelvic half view was developed to enhance understanding of the deeper pelvic anatomy. The following insights were incorporated into the illustration: (1) the cardinal ligament in gynecology partly overlaps with the vesicohypogastric fascia in colorectal surgery; (2) the obturator lymph nodes continue cephalad into the fossa of Marcille in urology; and (3) the deep uterine vein in gynecology corresponds to the inferior vesical vein in colorectal surgery.ConclusionBased on the dynamic illustration of pelvic anatomy from cross‐disciplinary discussions, we anticipate advancements in pelvic lymph node dissection aiming for curative and safe outcomes.

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Prognostic value of the nodal yield in oral squamous cell carcinoma: a systematic review and meta-analysis

Zhang

et al. 2023

Expert Review of Anticancer Therapy

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Higher nodal yield with robot-assisted pelvic lymph node dissection for bladder cancer compared to laparoscopic dissection: implications for more accurate staging

Cited by 5 publications

References 32 publications

Laparoscopic and Robotic-Assisted Extended Pelvic Lymph Node Dissection for Invasive Bladder Cancer: A Review

Laparoscopic and Robotic-Assisted Extended Pelvic Lymph Node Dissection for Invasive Bladder Cancer: A Review

Standardization of robot‐assisted pelvic lymph node dissection—Development of a common understanding of regional anatomy and surgical technique based on cross‐disciplinary discussion among colorectal surgery, urology, and gynecology

Prognostic value of the nodal yield in oral squamous cell carcinoma: a systematic review and meta-analysis

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