Laparoscopic para-aortic lymph node sampling: Development of a technique

Obesity in laparoscopic surgery

“…With the refinement of laparoscopic surgery, its effectiveness in the management of gynaecological cancers has been well documented [36e38]. Presently, there exist two validated approaches for laparoscopic para-aortic lymphadenectomy: trans-peritoneal [39] and extra-peritoneal approach [40].…”

Comparison Between Transperitoneal and Extraperitoneal Laparoscopic Paraaortic Lymphadenectomy in Gynecologic Malignancies

“…Furthermore, a laparoscopic surgical approach has been proven effective in minimizing operative morbidity, and reducing hospital stay and subsequent recovery, with comparable surgical and oncologic outcomes to laparotomy procedures. Two validated approaches for laparoscopic PAL exist: the transperitoneal approach [7] and the extraperitoneal approach [8]. The question that now remains to be answered is no longer laparotomy versus laparoscopy, but is now which of these approaches should be adopted for specific clinical cases.…”

Challenges of laparoscopic resection of abdominal neuroblastoma with lymphadenectomy

“…Once the learning curve has been overcome, laparoscopy is undeniably superior to open surgery [9~. Successful laparoscopic resection of the primary tumor and Iymph nodes correlates with proper visualization of the para-aortic and retroperitoneal structures [5]. The small size of the abdominal cavity in patient 5 did not allow adequate visualization of the precaval space and the contralateral right paraaortic lymph nodes, "although good visualization of the left retroperitoneal space was achieved.…”

“…Laparoscopic para-aortic lymph node sampling or dissection has been widely used by urologic and gynecologic surgeons [5,9,15]. Once the learning curve has been overcome, laparoscopy is undeniably superior to open surgery [9~.…”