Retroperitoneal laparoscopic para-aortic lymphadenectomy: stage IIB cervical carcinoma
Epublication WebSurg.com, Jul 2011;11(07). URL: http://websurg.com/doi/vd01en3343
This video demonstrates a retroperitoneal para-aortic lymphadenectomy for stage IIB epidermoid cervical carcinoma. This procedure allows to identify patients who should undergo extended field radiotherapy. The intervention is pursued with the dissection of the lympho-adipose tissue situated in the following anatomical boundaries: ureters and psoas muscles laterally, the iliac artery bifurcation —lower limit— and the left renal vein —superior limit. A diagnostic laparoscopy is first performed to rule out metastasis. A 10mm, 0-degree scope is used. An umbilical Hasson trocar is placed to explore the abdominal cavity. A left McBurney’s incision is then made, and the retroperitoneal space is created digitally. The Hasson trocar is placed with a 10mm balloon through the anterior incision. Two additional ports are placed in the anterior axillary line, a 12mm one and a 5mm one. The 5mm Ligasure™ V device and a grasping forceps are used throughout the whole intervention. At the end of the procedure, the lympho-adipose tissue is extracted using an Endobag through an enlarged peritoneal opening.