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- Title
Robotically assisted laparoscopy for paraaortic lymphadenectomy: technical description and results of an initial experience.
- Authors
Lambaudie, Eric; Narducci, Fabrice; Leblanc, Eric; Bannier, Marie; Jauffret, Camille; Cannone, Francesco; Houvenaeghel, Gilles
- Abstract
Objective: The objective of this study is to demonstrate the feasibility of robotically assisted laparoscopy paraaortic lymphadenectomy (PAL), isolated or combined with another procedure using different surgical approaches. Methods: From February 2007 to December 2010, 53 patients underwent paraaortic lymphadenectomy up to the left renal vein. We used three different approaches with three different positions for the robot in relation to the surgical procedure (isolated transperitoneal PAL, isolated extraperitoneal PAL, or transperitoneal PAL combined with another procedure). Thirty-nine patients underwent isolated lomboaortic lymphadenectomy and 14 a combined procedure. Information concerning installation time, operative time, peri- and postoperative complications, blood loss, lymph node count, and conversion rate was recorded. Results: For the whole population, mean installation time was 33 ± 18 min, mean operative time was 197 ± 81 min, and mean hospital stay was 3.9 ± 2.8 days. We observed 15.1% lymph node involvement at definitive pathology. Between isolated trans- and extraperitoneal PAL, only body mass index (BMI, 27.4 versus 22 kg/m) was significantly different. No difference was observed concerning mean number of lymph nodes or hospital stay. We observed statistical difference between combined and isolated PAL concerning mean operative time (256 versus 160 min), mean number of lymph nodes (7.8 versus 14.6), and hospital stay (5.9 versus 2.9 days). Conclusions: Although laparoscopic robotic-assisted PAL is a safe and feasible procedure, lymph node staging seems to be better if the procedure is isolated. In case of combined procedures, the surgical approach should be modified regarding patient BMI and the associated procedure, to increase lymph node count.
- Subjects
MEDICAL robotics; RENAL veins; KIDNEY blood-vessel surgery; LAPAROSCOPIC surgery complications; STATISTICAL significance; LYMPH node physiology; BODY mass index
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2012, Vol 26, Issue 9, p2430
- ISSN
1866-6817
- Publication type
Article
- DOI
10.1007/s00464-012-2205-8