Case reportRobotic-assisted laparoscopic retroperitoneal lymph node dissection
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
References (6)
- et al.
Long-term results of laparoscopic retroperitoneal lymph node dissectiona single-center 10-year experience
Urology
(2004) - et al.
Robotic pyeloplastytechnique and results
Urol Clin North Am
(2004) - et al.
Successful transfer of open surgical skills to a laparoscopic environment using a robotic interfaceinitial experience with laparoscopic radical prostatectomy
J Urol
(2003)
Cited by (105)
Outpatient robotic assisted retroperitoneal lymph node dissection
2022, Urology Case ReportsPrimary Robot-assisted Retroperitoneal Lymph Node Dissection for Men with Nonseminomatous Germ Cell Tumor: Experience from a Multi-institutional Cohort
2021, European Urology FocusCitation Excerpt :However, increased awareness of the long-term effects of chemotherapy, including secondary malignancies, metabolic syndrome, infertility, decreased renal function, and pulmonary toxicity, has influenced some groups to reconsider RPLND [15]. Recently, minimally invasive RPLND has emerged as an alternative to the open approach, with several series showing both safety and efficacy [16–21]. Today, in experienced centers, robot-assisted retroperitoneal lymph node dissection (RA-RPLND) for men with low clinical stage NSGCT has attracted attention as a potential treatment approach for patients who do not opt for surveillance.
Robot-assisted retroperitoneal lymphadenectomy: The state of art
2021, Asian Journal of UrologyCitation Excerpt :However, widespread adoption of this approach, even in the other fields of urology, has limited due to the technical challenges and the need for extensive training in laparoscopic surgery [19–22]. The robotic approach to RPLND was subsequently described to reach the same oncologic efficacy of O-RPLND while minimizing the morbidity associated with the procedure and decreasing the long learning curve related to the pure laparoscopic technique [6,8–10]. The robotic approach, with better ability from the wristed instruments, facilitates the control and suturing of the great vessels in case of injury, clearly improving the safety of the procedure [1].
Lymph Node Dissection in Testicular Cancer: The State of the Art and Future Perspectives
2024, Current Oncology Reports