Robotic extraperitoneal aortic lymphadenectomy: Development of a technique.
OBJECTIVE
To develop a robotic technique for extraperitoneal aortic lymphadenectomy in cadavers followed by application in a patient with advanced cervical cancer.


METHODS
Two fresh frozen female torso cadavers were used to develop the correct placement of the robotic column and trocars, respectively, to allow for a safe and adequate performance of aortic lymphadenectomy using the da Vinci S system. The resulting technique was applied to a patient with cervical cancer Stage IB2 presenting with enlarged aortic nodes.


RESULTS
Appropriate sites for trocar and robotic column placement were identified in the female cadavers. In the patient, the operating, docking, and console times were 103, 3.5, and 49 minutes, respectively. The blood loss was 30 ml. Selective removal of 5 enlarged aortic nodes revealed no evidence of metastases.


CONCLUSIONS
Robotic extraperitoneal aortic lymphadenectomy is feasible provided there is proper robotic trocar and column placement. The operating time and number of aortic nodes selectively removed by robotics in this patient are within the range of those reported with an extraperitoneal systematic aortic lymphadenectomy by laparoscopy.
Magrina
Javier F
JF
Department of Obstetrics and Gynecology, Mayo Clinic Arizona, 5777 East Mayo Boulevard, Phoenix, Arizona 85054, USA. jmagrina@mayo.edu
Kho
Rosanne
R
Montero
Regina P
RP
Magtibay
Paul M
PM
Pawlina
Wojciech
W
D000328:Adult; D001011:Aorta; D002102:Cadaver; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000601:surgery*; D009367:Neoplasm Staging; D012371:Robotics / Q000379:methods*; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*