title: Single-port laparoscopy and extraperitoneal para-aortic lymphadenectomy: about fourteen consecutive cases.
abstract: OBJECTIVE
  To report the feasibility and reproducibility of single port extraperitoneal para-aortic lymphadenectomy in locally advanced cervical cancer.
  
  
  METHODS
  The same single port was used for the transperitoneal step and the extraperitoneal approach used thereafter (in the absence of peritoneal disease) for the lymphadenectomy. Para-aortic lymphadenectomy was performed via a left-sided extraperitoneal approach.
  
  
  RESULTS
  Fourteen consecutive patients with cervical cancer underwent a laparoscopic staging procedure (3 stage IB2, 10 IIB and 1 stage IVA). No patient had para-aortic FDG uptake on PET/CT. In one case lymphadenectomy was unfeasible because of vascular anomalies of the renal vessels (low insertion of 2 left renal arteries). The median operative time was 190 min (range, 135-250). The median number of lymph nodes removed was 14 [range, 2-23]. The definitive pathological analysis revealed that three patients had metastatic disease. No conversion to conventional multiport laparoscopy was necessary.
  
  
  CONCLUSIONS
  This series reports that para-aortic lymphadenectomy technique via the extraperitoneal approach with a multichannel single port is feasible and reproducible.
authors.affiliation: Department of Surgery, Institut Gustave Roussy and University Paris Sud. Villejuif, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Gouy
authors.forename: Aminata
authors.initials: A
authors.lastname: Kane
authors.forename: Catherine
authors.initials: C
authors.lastname: Uzan
authors.forename: Tristan
authors.initials: T
authors.lastname: Gauthier
authors.forename: Jennifer
authors.initials: J
authors.lastname: Gilmore
authors.forename: Philippe
authors.initials: P
authors.lastname: Morice
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008197:Lymph Node Excision / Q000379:methods*; D008875:Middle Aged; D002583:Uterine Cervical Neoplasms / Q000601:surgery*