title: Single-port laparoscopy and extraperitoneal para-aortic lymphadenectomy: 3 consecutive cases.
abstract: OBJECTIVE
  We report the feasibility and the technique of single-port extraperitoneal para-aortic lymphadenectomy in locally advanced cervical cancer.
  
  
  METHODS
  The same single port was used for the transperitoneal step (to discriminate intraperitoneal disease) and the extraperitoneal approach used thereafter (in the absence of peritoneal or ovarian spread) for the lymphadenectomy. Para-aortic lymphadenectomy was performed via the left-sided extraperitoneal approach by a 2- to 3-cm incision, which was made 1 cm above the usual incision to the left of McBurney's point. We used conventional instruments in all cases.
  
  
  RESULTS
  Three consecutive patients with cervical cancer had undergone a pretherapeutic laparoscopic staging procedure (1 stage IB2 and 2 stage IIB). The histologic types were squamous carcinoma (n = 2) and adenocarcinoma (n = 1). No patients had pelvic or para-aortic uptakes on preoperative positron emission tomography computed tomography imaging. The mean operative time was 223 minutes (range, 210-250 minutes). The mean number of lymph nodes removed was 19 (range, 15-23). The definitive pathological analysis had revealed that one patient had metastatic disease. No failures occurred with the single-port procedure, and no conversion to conventional multiport laparoscopy was reported.
  
  
  CONCLUSIONS
  This preliminary series reports on the feasibility of the para-aortic lymphadenectomy technique via the extraperitoneal approach with a multichannel single port using conventional instruments. Nevertheless, the safety of this procedure (compared to conventional laparoscopic approach) needs to be explored in a further larger study.
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: Catherine
authors.initials: C
authors.lastname: Uzan
authors.forename: Aminata
authors.initials: A
authors.lastname: Kane
authors.forename: Tristan
authors.initials: T
authors.lastname: Gauthier
authors.forename: Philippe
authors.initials: P
authors.lastname: Morice
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery*; D008875:Middle Aged; D009367:Neoplasm Staging; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000601:surgery*