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Review
. 2017 Apr-Jun;6(2):51-57.
doi: 10.1016/j.gmit.2016.01.003. Epub 2016 Feb 8.

Laparoscopic technique of para-aortic lymph node dissection: A comparison of the different approaches to trans- versus extraperitoneal para-aortic lymphadenectomy

Soshi Kusunoki  1 , Kuan-Gen Huang  2 , Angelito Magno  3 , Chyi-Long Lee  2
Affiliations
Review

Laparoscopic technique of para-aortic lymph node dissection: A comparison of the different approaches to trans- versus extraperitoneal para-aortic lymphadenectomy

Soshi Kusunoki et al. Gynecol Minim Invasive Ther. 2017 Apr-Jun.

Abstract

Since Dr Dargent first reported endoscopic surgery using retroperitoneal pelvicoscopy to perform pelvic lymph node sampling in 1987, many literature reviews on the safety and feasibility of laparoscopic staging surgery of gynecologic malignancies have been published. However, the procedure of laparoscopic lymphadenectomy is more difficult to perform due to the limited surgical space and associated technical problems. Especially in the para-aortic lymphadenectomy procedure, there are many barriers to overcome in the surgical field, learning curve, and technique. We present a review of lymphadenectomy, especially para-aortic lymphadenectomy.

Keywords: extraperitoneal; para-aortic lymphadenectomy; transperitoneal.

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Conflict of interest statement

Conflicts of interest: The authors have no conflicts of interest relevant to this article.

Figures

Figure 1
Figure 1
(A, B) Trocar placements for transperitoneal para-aortic lymphadenectomy. (C) Trocar placement for extraperitoneal para-aortic lymphadenectomy.
Figure 2
Figure 2
Elevation of the peritoneum to form a tent in the case of an obscure surgical field.
Figure 3
Figure 3
Completed laparoscopic transperitoneal para-aortic lymphadenectomy. IMA = inferior mesenteric artery; IVC = inferior vena cava; LCI = left common iliac artery; RCI = right common iliac artery.
See this image and copyright information in PMC

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