Laparoscopic Retroperitoneal Lymph-Node Dissection with the Waterjet Is Technically Feasible and Safe in Testis-Cancer Patient

Corvin, Stefan; Sturm, Wolfgang; Schlatter, Evelin; Anastasiadis, Aristotelis G.; Kuczyk, Markus A.; Stenzl, Arnulf

doi:10.1089/end.2005.19.823

Cited by 24 publications

(6 citation statements)

References 21 publications

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“…In the primary staging setting, several recent studies showed that L‐RPLND in expert hands is a possible procedure in the management of patients with testicular cancer who require surgery to address the retroperitoneal lymph nodes [75,76,82–88]. Rassweiler et al.…”

Section: Laparoscopic (L)‐rplndmentioning

confidence: 99%

Retroperitoneal lymph node dissection after chemotherapy

2009

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Retroperitoneal lymph node dissection after chemotherapy (PC‐RPLND) plays a crucial role in managing patients with advanced germ cell tumours (GCTs). In the last few years improvements in radiographic staging, a better understanding of the role of serum tumour markers, and the introduction of cisplatin‐based chemotherapy have all contributed to this surgical therapy. PC‐RPLND is necessary when residual radiographic abnormalities are present after chemotherapy. The need for a PC‐RPLND in the face of normal findings from computed tomography (CT) is controversial. CT criteria alone are not sufficiently reliable to distinguish viable tumour or teratoma from necrosis. No combination of variables can predict negative retroperitoneal pathology with sufficient accuracy after induction chemotherapy. Unresected teratoma or viable GCT are at least partly chemorefractory and, if untreated, will progress. So completeness of resection is an independent and consistent predictive variable of clinical outcome. In PC‐RPLND surgical margins should not be compromised in an attempt to preserve ejaculation, although nerve‐sparing dissections are possible in patients with marker normalization after chemotherapy and necrotic tissue in frozen‐section histology. In these patients nerve‐sparing techniques and the reduction of surgical field to the left‐ or right‐sided template are applicable to preserve antegrade ejaculation and consecutive fertility. The size and location of residual masses coupled with the retroperitoneal desmoplastic reaction make PC‐RPLND a technically demanding procedure that should be performed by experienced surgeons in dedicated referral centres.

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Section: Laparoscopic (L)‐rplndmentioning

confidence: 99%

Retroperitoneal lymph node dissection after chemotherapy

2009

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“…Early use of waterjet dissection has been reported in liver and kidney surgery. 10,30,31,34,35,52 Subsequently, waterjet dissection was used in orthopedic procedures, 8,9,16,41,48 urological and hepatic surgery, 2,45,56 parotid surgery, 18,47 ophthalmological surgery, 6,18,19,[53][54][55] with endovascular techniques, 20 and in thoracoabdominal surgery. 15,17 The first application of waterjet dissection in neurosurgery was reported by Terzis et al 51 in 1989.…”

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confidence: 99%

Waterjet dissection of the vestibulocochlear nerve: an experimental study

Tschan

Gaab

Krauss

et al. 2009

JNS

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“…Hydrojet has been used during laparoscopy for more than 20 years. 12 Hydro-Jet dissection requires a special hydro-jet generator 13,14 and produces a high-pressure jet of between 20 to 60 BAR. The “original” hydro-jet systems forced the irrigant through a central cannula, and other methods also used an irrigation probe with a hypodermic needle type of tip.…”

Section: Discussionmentioning

confidence: 99%