title: Laparoscopic sentinel lymph node dissection--a novel technique for the staging of prostate cancer.
abstract: OBJECTIVE
  Pelvic lymph node metastases indicate a poor prognosis for prostate cancer patients. The aim of this study was to evaluate the suitability of laparoscopic radioisotope guided sentinel lymph node (SLN) dissection in staging of prostate carcinoma.
  
  
  METHODS
  28 patients with prostate cancer and intermediate or high risk for lymph node metastases considered for external beam radiotherapy underwent laparoscopic pelvic lymphadenectomy at our institution. For visualization of individual SLN distribution, an image fusion system consisting of a gamma-camera with integrated X-ray tube was used. During laparoscopic lymphadenectomy, SLN were identified using a laparoscopic gamma probe.
  
  
  RESULTS
  Preoperative imaging and laparoscopic gamma probe allowed an excellent delineation of SLN. 57% (preoperative imaging) as well as 48% (intraoperative measurements) of SLN were found outside the obturator fossa. All SLN were removed successfully without intra- or postoperative complications. Despite extended lymphadenectomy, no significant lymphocele appeared. 10 lymph node metastases were found in 7 out of the 31 patients (23%) with 3 of the 10 metastases lying outside the obturator fossa representing the standard lymphadenectomy area.
  
  
  CONCLUSIONS
  The present data demonstrate that laparoscopic SLN dissection is an excellent minimally invasive and technically feasible tool for staging of intermediate and high risk prostate cancer.
authors.affiliation: Department of Urology, Eberhard-Karls-University, Tuebingen, Germany. stefan.corvin@med.uni-tuebingen.de
authors.forename: Stefan
authors.initials: S
authors.lastname: Corvin
authors.forename: David
authors.initials: D
authors.lastname: Schilling
authors.forename: Kai
authors.initials: K
authors.lastname: Eichhorn
authors.forename: Ilse
authors.initials: I
authors.lastname: Hundt
authors.forename: Joerg
authors.initials: J
authors.lastname: Hennenlotter
authors.forename: Aristotelis G
authors.initials: AG
authors.lastname: Anastasiadis
authors.forename: Markus
authors.initials: M
authors.lastname: Kuczyk
authors.forename: Roland
authors.initials: R
authors.lastname: Bares
authors.forename: Arnulf
authors.initials: A
authors.lastname: Stenzl
mesh_terms: D000368:Aged; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000473:pathology; D010535:Laparoscopy / Q000379:methods; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010386:Pelvic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000556:secondary*; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery*; D011877:Radionuclide Imaging; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional