Robotic Transperitoneal Infrarenal Aortic Lymphadenectomy for Gynecologic Malignancy: A Left Lateral Approach

Robotic infrarenal paraaortic and pelvic nodal staging for endometrial cancer: feasibility and lymphatic complications

“…In patients with a paraaortic LND including the infrarenal area the median number of retrieved pelvic lymph nodes was 18 (range 4-39) and the median number of paraaortic lymph nodes was 10 (2-39); of the latter, the median number of infrarenal nodes was five (range [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. In the group of 123 histologically proven high risk EC patients without pre-or intraoperative signs of disseminated disease, 23 (18.7%) were node-positive; 13 (10.6%) had only metastatic pelvic lymph nodes, eight (6.5%) had both pelvic and paraaortic metastases and two women (1.6%) had isolated paraaortic metastases, one (0.8%) involving the infrarenal area only.…”

Robotic retroperitoneal lymph node dissection in gynaecological neoplasms: comparison of extraperitoneal and transperitoneal lymphadenectomy

“…A total of 107 and 540 search results were retrieved during the performed search in PubMed and Scopus databases, respectively, among of which 18 studies were identified as eligible for inclusion in our review [15][16][17][18][19][20][21][22][23][24][25][26][27][28][39][40][41]. One additional study was identified through hand-searching of references [38].…”

Robotic-assisted infrarenal aortic lymphadenectomy and pelvic lymphadenectomy for endometrial staging using a single docking procedure

“…All of the staging procedures were completed without the relocation of the patient side cart. Different approaches for infrarenal lymph node access, including a right extraperitoneal approach (Magrina et al, 2009), left transperitoneal lateral approach (Jacob et al, 2011) and a transperitoneal midline approach with a head docking procedure (Magrina et al, 2010), have been identified. All of these techniques require a relocation procedure and additional trocar insertions, or they are performed in patients who require only para-aortic lymphadenectomy.…”

“…Jacob et al reported a left lateral approach for robotic transperitoneal infrarenal aortic lymphadenectomy that included patient rotation and a redocking procedure to provide access to the pelvis for pelvic lymphadenectomy (Jacob et al, 2011). This new technique uses a total of six abdominal trocars for pelvic and upper abdominal dissection.…”

“…However, the dissection of lymph nodes above the IMA with robotic-assisted surgery has limitations due to the docking procedure that is used to access the entire abdomen and complete the endometrial staging procedure. The relocation of the robotic column has been suggested previously (Magrina et al, 2009;Jacob et al, 2011;Magrina et al, 2010;Narducci et al, 2009). As we know, there is no published study in the literature including complete endometrial staging using a single docking procedure.…”