Minimally Invasive Retroperitoneal Lymphadenectomy

J Endourol. 2018 May;32(S1):S97-S104. doi: 10.1089/end.2018.0164.

Abstract

The feasibility of laparoscopic retroperitoneal lymphadenectomy (RLA) for testicular cancer was shown >25 years ago. Initially the indication was clinical stage I (CS I) nonseminomatous germ cell tumor (NSGCT). Compared with that of open surgery, the morbidity was much decreased. However, in Europe, surgery for CS I is now replaced by chemotherapy. A relatively new indication is laparoscopic retroperitonal lymphadenectomy for small unilateral residual tumor after chemotherapy. The technique of unilateral lymphadenectomy for both indications is described in detail and with a video. The most recent development is bilateral laparoscopic RLA for residual tumors larger than 5 cm.

Keywords: laparoscopic surgery; minimally invasive surgery; retroperitoneal lymph node dissection; retroperitoneal lymphadenectomy.

MeSH terms

  • Adult
  • Biopsy
  • Europe
  • Humans
  • Laparoscopy
  • Lymph Node Excision*
  • Lymphatic Metastasis
  • Male
  • Minimally Invasive Surgical Procedures*
  • Neoplasm Staging
  • Neoplasm, Residual / surgery
  • Neoplasms, Germ Cell and Embryonal / surgery*
  • Patient Positioning
  • Postoperative Period
  • Preoperative Period
  • Retroperitoneal Space / surgery*
  • Seminoma / surgery
  • Testicular Neoplasms / surgery*

Supplementary concepts

  • Nonseminomatous germ cell tumor
  • Testicular Germ Cell Tumor