title: Post-chemotherapy robotic bilateral retroperitoneal lymph node dissection using a novel single-dock technique.
abstract: There have been no previous reports of post-chemotherapy robotic bilateral retroperitoneal lymph node dissection (RPLND) using a single-dock technique. One deterrent of robotic RPLND is that accessing bilateral retroperitoneal spaces requires patient reposition and surgical robot redocking, therefore increasing operative time. Herein we provide the first step-by-step description of a single-dock technique for robotic bilateral RPLND in the post-chemotherapy setting. We describe port placement and technique for robot positioning to optimize access to bilateral retroperitoneal spaces with a single dock. We also demonstrate the feasibility of sparing the inferior mesenteric artery when utilizing this approach. This single-dock approach was used on two patients at our institution who had residual paracaval masses following chemotherapy for metastatic testicular cancer. Mean operative time was 6 h, and neither patient had significant blood loss or suffered from any peri-operative complications.
authors.affiliation: Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Stout
authors.affiliation: Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Samit D
authors.initials: SD
authors.lastname: Soni
authors.affiliation: Department of Urology, Houston Methodist Hospital, 6560 Fannin Street, Suite 2100, Houston, TX, 77030, USA. acg622@gmail.com.|Methodist Institute for Technology, Innovation and Education, Houston Methodist Hospital, Houston, TX, USA. acg622@gmail.com.
authors.forename: Alvin C
authors.initials: AC
authors.lastname: Goh
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents; D016063:Blood Loss, Surgical; D005240:Feasibility Studies; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy / Q000601:surgery*; D061646:Operative Time; D012187:Retroperitoneal Space; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures; D013736:Testicular Neoplasms / Q000188:drug therapy / Q000601:surgery*
chemical_list: D000970:Antineoplastic Agents
keywords: Retroperitoneal lymph node dissection; Robotic surgery; Surgical techniques; Testicular cancer