Robotic-assisted para-aortic lymphadenectomy: Technique and indications in gynecological oncology

Jordi Ponce; Sergi Fernández; Marc Barahona; José Manuel Martínez; Carlos Ortega; Lola Martí

doi:10.1016/j.bpobgyn.2023.102401

Robotic-assisted para-aortic lymphadenectomy: Technique and indications in gynecological oncology

Best Pract Res Clin Obstet Gynaecol. 2023 Dec:91:102401. doi: 10.1016/j.bpobgyn.2023.102401. Epub 2023 Aug 21.

Authors

Jordi Ponce¹, Sergi Fernández², Marc Barahona³, José Manuel Martínez⁴, Carlos Ortega⁵, Lola Martí⁶

Affiliations

¹ Gynecologic Department, University Hospital of Bellvitge (IDIBELL), University of Barcelona, Spain. Electronic address: jponce@bellvitgehospital.cat.
² Gynecologic Department, University Hospital of Bellvitge (IDIBELL), University of Barcelona, Spain. Electronic address: sfernandez@bellvitgehospital.cat.
³ Gynecologic Department, University Hospital of Bellvitge (IDIBELL), University of Barcelona, Spain. Electronic address: mbarahona@bellvitgehospital.cat.
⁴ Gynecologic Department, University Hospital of Bellvitge (IDIBELL), University of Barcelona, Spain. Electronic address: jmartinezgar@bellvitgehospital.cat.
⁵ Gynecologic Department, University Hospital of Bellvitge (IDIBELL), University of Barcelona, Spain. Electronic address: cortega@bellvitgehospital.cat.
⁶ Gynecologic Department, University Hospital of Bellvitge (IDIBELL), University of Barcelona, Spain. Electronic address: lmarti@bellvitgehospital.cat.

PMID: 37678062
DOI: 10.1016/j.bpobgyn.2023.102401

Abstract

The benefits of minimally-invasive surgeries have been documented, and they have been established as the preferred approach for gynecological surgeries. With the development of robotic surgery, many highly complex surgeries can benefit from these advantages. Due to the complexity of aortocaval lymphadenectomy, surgical technique protocols have been described to reduce risks by maximizing benefits. We describe the technique using five ports (4 robotic arms and an assistant) to work the upper abdominal field, and different instruments recommended in each of their positions to reduce errors and optimize surgical time. After the "step by step" description, we summarize indications of aortocaval lymphadenectomy for every gynecological cancer in different stages.

Keywords: Gynecology; Lymphadenectomy; Minimally-invasive surgery; Oncology; Robotic surgery.

Publication types

Review

MeSH terms

Female
Genital Neoplasms, Female* / surgery
Gynecologic Surgical Procedures / methods
Humans
Laparoscopy* / methods
Lymph Node Excision / methods
Minimally Invasive Surgical Procedures
Robotic Surgical Procedures* / methods