Elsevier

Urology

Volume 67, Issue 1, January 2006, Pages 199.e7-199.e8
Urology

Case report
Robotic-assisted laparoscopic retroperitoneal lymph node dissection

https://doi.org/10.1016/j.urology.2005.07.022Get rights and content

Abstract

Minimally invasive laparoscopic techniques have been applied to the staging and treatment of testicular cancer during the performance of retroperitoneal lymph node dissection. The da Vinci Surgical System potentially improves the safety and accuracy of this approach. We present what we believe to be the first published description of robotic-assisted retroperitoneal lymph node dissection, which was performed in an 18-year-old man with a mixed germ cell tumor. This case demonstrates the technical feasibility, safety, and accuracy of robotic-assisted retroperitoneal lymph node dissection and expands the role of minimally invasive techniques in urologic oncology.

Section snippets

Case report

An 18-year-old man presented with an enlarging right scrotal mass. Scrotal ultrasonography demonstrated a 3.5-cm solid mass of the right testis, and tumor markers were significant for elevated beta-human chorionic gonadotropin (11.2 mIU/mL; normal less than 2 mIU/mL). The patient underwent right radical orchiectomy. Pathologic examination demonstrated a mixed germ cell tumor, predominately mature teratoma with focal seminoma, and no vascular or lymphatic invasion. Staging computed tomography

Comment

Since its inception in 1992,5 laparoscopic RPLND has been shown to be technically feasible, safe, and efficacious.1, 6 This technique has reduced the morbidity of surgery for testicular cancer, while maintaining excellent cancer control with long-term follow-up, even in patients with nodal disease spread.1

Despite its advantages, laparoscopic RPLND is technically challenging, necessitating a skill set that is not easily acquired. However, with the advent of robotic-assisted surgery, surgeons can

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