Para-aortic and Right Obturator Lymphadenectomy for Surgical Staging of Advanced Cervical Cancer through the TU-LESS Extraperitoneal Approach

The Transumbilical Laparoendoscopic Single-Site Extraperitoneal Approach for Pelvic and Para-Aortic Lymphadenectomy: A Technique Note and Feasibility Study

“…We initially attempted to employ the TU-LESS extraperitoneal approach in the surgical staging procedures for a patient with advanced cervical cancer in order to accurately delineate the radiographic field. The PALN and right enlarged obturator LN biopsy were performed easily via this novel technique (26). Further exploration and practice of this technique were conducted, and the primary findings of our study confirmed that the TU-LESS extraperitoneal approach is feasible for systematic PLN and PALN.…”

“…The median blood loss was 100 ml (range 100-300) and no patient required blood transfusion. Concerning the LN yields, the median count of para-aortic LNs was 18 (range of 7-30), and the retrieved pelvic LNs was 26.5 (range [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35]. Three EC patients had positive LNs, two with pelvic nodal metastasis and one with para-aortic nodal involvement.…”

An advantageous technique for fertility sparing staging surgery of epithelial ovarian cancer with a single umbilical incision

“…Thus we designed an innovative extraperitoneal approach through the same umbilical incision which achieves satisfactory visualization and lymph node retrieval of both pelvic and para-aortic areas 3 4. Also, we found that the approach was particularly suitable for fertility sparing because it can maintain an intact peritoneum and reduce intraperitoneal adhesion, which might contribute to a future pregnancy.…”