Open AccessRobot-assisted laparoscopic retroperitoneal lymph node dissection: a minimally invasive surgical approach for testicular cancer
Author(s) -
Harsha R. Mittakanti,
James R. Porter
Publication year - 2020
Publication title -
translational andrology and urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.721
H-Index - 27
eISSN - 2223-4691
pISSN - 2223-4683
DOI - 10.21037/tau.2019.12.36
Subject(s) - retroperitoneal lymph node dissection , medicine , testicular cancer , surgery , dissection (medical) , lymphadenectomy , laparoscopy , retroperitoneal space , lymph node , general surgery , chemotherapy
Retroperitoneal lymph node dissection (RPLND) can been employed as primary treatment for stage I non-seminomatous germ cell tumor (NSGCT) as well as for treatment of post-chemotherapy masses. Open RPLND (O-RPLND) has long been the standard approach for lymphadenectomy, but is associated with significant morbidity. Laparoscopic RPLND (L-RPLND) was developed to mitigate the morbidity associated with O-RPLND, but is a technically challenging procedure requiring significant experience with laparoscopic dissection and suturing to remove lymph nodes behind the great vessels and to control vascular injury. Robotic RPLND (R-RPLND) has gained traction in recent years as an alternative to both O-RPLND and L-RPLND. With superior instrument dexterity and better visualization compared to L-RPLND, and with decreased morbidity, compared to O-RPLND, R-RPLND can be performed safely and effectively. With the latest advances in robotic technology, one can perform a full bilateral dissection without needing to reposition the patient or redock the robot. R-RPLND has been applied for both primary treatment as well as in patients with post-chemotherapy residual abdominal masses.