title: The "peritoneal scaffold" technique of extended pelvic lymph node dissection during radical prostatectomy: A novel technique.
abstract: BACKGROUND
  Laparoscopic or robotic-assisted laparoscopic radical prostatectomy (RALP) is a frequently used approach for localized carcinoma prostate. For intermediate and high-risk cancers, extended pelvic lymph node dissection (e-PLND), is often performed. Conventional e-PLND involves piecemeal retrieval of lymphatic tissue. We describe a novel technique of laparoscopic e-PLND, which involves en-masse removal of pelvic lymph nodes from each side, based on an overlying peritoneal scaffold.
  
  
  METHODS
  Fifteen cases of intermediate and high-risk carcinoma prostate underwent laparoscopic radical prostatectomy (LRP) with peritoneal scaffold based e-PLND within a period of 1 year. We describe the surgical techqniue and outcomes in terms of operative time and lymph nodes retrieved.
  
  
  RESULTS
  The mean operating times for "peritoneal scaffold" lymphatic dissection was 48 min (38-64). The total number of lymph nodes retrieved was 18 (14-22). There were no cases with postoperative lymph collection or hematoma.
  
  
  CONCLUSIONS
  The "peritoneal scaffold" technique of e-PLND is a novel technique, which involves having a peritoneal scaffold to bind and hold all the lymphatic tissues together in its anatomical orientation during dissection. This enables complete retrieval of specimen during LRP and RALP.
authors.affiliation: Department of Urology, Asian Institute of Nephrology and Urology, Hyderabad, Telangana, India.
authors.forename: Chiruvella
authors.initials: C
authors.lastname: Mallikarjuna
authors.affiliation: Department of Urology, Asian Institute of Nephrology and Urology, Hyderabad, Telangana, India.
authors.forename: Prasant
authors.initials: P
authors.lastname: Nayak
authors.affiliation: Department of Urology, Asian Institute of Nephrology and Urology, Hyderabad, Telangana, India.
authors.forename: Syed Mohammed
authors.initials: SM
authors.lastname: Ghouse
authors.affiliation: Department of Urology, Asian Institute of Nephrology and Urology, Hyderabad, Telangana, India.
authors.forename: K Purnachandra
authors.initials: KP
authors.lastname: Reddy
authors.affiliation: Department of Urology, Asian Institute of Nephrology and Urology, Hyderabad, Telangana, India.
authors.forename: Deepak Reddy
authors.initials: DR
authors.lastname: Ragoori
authors.affiliation: Department of Urology, Asian Institute of Nephrology and Urology, Hyderabad, Telangana, India.
authors.forename: M T
authors.initials: MT
authors.lastname: Bendigeri
authors.affiliation: Department of Urology, Asian Institute of Nephrology and Urology, Hyderabad, Telangana, India.
authors.forename: Siva
authors.initials: S
authors.lastname: Reddy
keywords: Carcinoma prostate; extended pelvic lymph node dissection; laparoscopic pelvic lymph node dissection; radical prostatectomy