Three Types of Minimally Invasive Paraaortic Lymphadenectomy

Abstract

Study Objective

Originally open para-aortic dissection is very invasive. To reduce patient morbidity, we introduced minimally invasive extraperitoneal techniques.

Design

Techniques for minimally invasive para-aortic lymphadenectomy will be shown.

Setting

All operations were conducted in a general hospital in Japan.

Patients were all placed in the lithotomy position. Patient positioning was the same irrespective of whether procedures were single port or multi-port.

Patients or Participants

We began laparoscopic para-aortic dissection in 1998 and da Vinci XP surgery in 2018. The SP system was introduced in 2023. In totally, we have performed more then 900 para-aortic lymphadenectomy surgeries.

Interventions

Techniques for minimally invasive para-aortic lymphadenectomy using various approaches will be shown. The progression of techniques using surgical robots top maximize minimally invasiveness will be described, specifically focusing on how-to's in real surgical circumstances.

Measurements and Main Results

No patients underwent blood transfusion, and the post-operative courses of all patients were uneventful. Patients could ambulate and take a regular diet the day after surgery.

Conclusion

Robotic surgery for para-aortic lymphadenectomy is feasible and makes this once invasive surgery patient-friendly. Both laparoscopy and robotics offer safe dissection and a good cosmetic result for patients.