Robotic-assisted laparoscopic pelvic lymphadenectomy for bladder cancer: a surgical atlas.
BACKGROUND
Recently, robotic approaches to cystectomy have been reported. Lymphadenectomy remains an important diagnostic component of cystectomy. As with resection of the primary tumor, the use of new technologies must not compromise the oncological benefits of lymphadenectomy, We describe our approach to and results of robotic-assisted laparoscopic pelvic lymphadenectomy in cystectomy.


METHODS
We describe the technique of standard and extended pelvic lymph node dissection during robotic-assisted cystectomy. The classic da Vinci or the da Vinci S robotic platform is utilized for lymphadenectomy.


RESULTS
Twenty-eight patients underwent a standard dissection with a mean number of lymph nodes removed of 19 (range, 8-33). Extended lymph node dissection has been performed in 22 patients with a mean of 30 lymph nodes removed (range, 12-39). No surgical complications have occurred related to the lymphadenectomy.


CONCLUSIONS
Robotic laparoscopic pelvic lymphadenectomy is feasible and safe, and is equivalent in efficacy to open approaches in bladder cancer.
Pruthi
Raj S
RS
Division of Urologic Surgery, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA.
Wallen
Eric M
EM
D015653:Cystectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008197:Lymph Node Excision / Q000379:methods*; D008207:Lymphatic Metastasis; D010388:Pelvis; D012371:Robotics / Q000295:instrumentation*; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000601:surgery*