title: Robotic transperitoneal infrarenal aortic lymphadenectomy for gynecologic malignancy: a left lateral approach.
abstract: OBJECTIVE
  To describe the technique and report patient outcomes of a left lateral approach for robotic transperitoneal infrarenal aortic lymphadenectomy with subsequent pelvic surgery in patients with gynecologic malignancy.
  
  
  METHODS
  Outcome data were collected retrospectively from March 2009 to September 2010 for all patients undergoing a left lateral approach for robotic transperitoneal aortic lymphadenectomy using a right lateral decubitus position by a single surgeon. Outcomes were analyzed and compared.
  
  
  RESULTS
  The median total operating time was 213 minutes (range, 186-265). The median body mass index was 25.2 kg/m(2) (range, 22.5-32.1). The median estimated blood loss was 150 mL (range, 50-550). The median length of hospital stay was 1 day (range, 1-2). The mean number of para-aortic lymph nodes was 8.2 (range 4-17). There were no conversions or perioperative complications in this 5-patient series. The mean follow-up was 12.8 months (range, 8-20). All patients underwent concomitant robotic hysterectomy and pelvic lymphadenectomy.
  
  
  CONCLUSIONS
  A left lateral approach for robotic transperitoneal infrarenal aortic lymphadenectomy using a right lateral decubitus position is safe and feasible. Minimal patient repositioning provides access for pelvic surgery using the same abdominal trocar placement.
authors.affiliation: Department of Gynecology, Mayo Clinic, Phoenix, Arizona, USA. jacob.kristina@mayo.edu
authors.forename: Kristina A
authors.initials: KA
authors.lastname: Jacob
authors.forename: Vanna
authors.initials: V
authors.lastname: Zanagnolo
authors.forename: Javier F
authors.initials: JF
authors.lastname: Magrina
authors.forename: Paul M
authors.initials: PM
authors.lastname: Magtibay
mesh_terms: D000368:Aged; D001012:Aorta, Abdominal; D016889:Endometrial Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D010535:Laparoscopy / Q000379:methods*; D008197:Lymph Node Excision / Q000379:methods*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D056888:Patient Positioning; D010388:Pelvis; D012371:Robotics / Q000379:methods*