Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan;32(1):e2.
doi: 10.3802/jgo.2021.32.e2. Epub 2020 Oct 26.

A new technique of laparoscopic para-aortic lymphadenectomy optimizes perioperative outcome

Yonghong Lin  1 , Li He  2 , Youwen Mei  2
Affiliations

A new technique of laparoscopic para-aortic lymphadenectomy optimizes perioperative outcome

Yonghong Lin et al. J Gynecol Oncol. 2021 Jan.

Abstract

Objective: The aim of the present study was to introduce a new technique for laparoscopic para-aortic lymphadenectomy (PAL): an invented retroperitoneum suspension needle combined with modified trocar placement.

Methods: This prospective pilot study randomly categorized women with cervical cancer of stage I-II into 2 groups. The patients in the study group would have laparoscopic PAL with our new technique, while those in the control group with control method. Patients' characteristics and perioperative outcomes were compared between the 2 groups.

Results: A total of 37 patients were included in our study, of which 20 cases in the study group and 17 cases in the control group. As a result, the mean number of para-aortic lymph nodes (PALNs) resected in the study group was significantly more than that in the control group (p<0.001). The time for resecting PALNs (p<0.001) and total operative time (p<0.001) in the study group decreased significantly than those in the control group.

Conclusions: For laparoscopic PAL, this new technique was effective and practical.

Keywords: Cervical Cancer; Laparoscopy; Lymphadenectomy; Para-aortic Lymph Node.

PubMed Disclaimer

Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1. A suspension needle: A, curved tip; B, circle loop; C, the needle's handle; and D, a small groove on top of the needle.
Fig. 2
Fig. 2. The process of suspending retroperitoneum with our needle. (A) abdominal wall is punctured by the needle. (B) retroperitoneum is punctured by the needle. (C) The circle is taken out of the groove. (D) The needle is drawn out of retroperitoneum. (E) The circle is hooked up by the groove on the other side of retroperitoneum again and pulled out of abdominal wall. (F) The exposed surgical field after retroperitoneum of both sides are suspended.
Fig. 3
Fig. 3. Sketch map of modified trocar placement: A, a 10 mm trocar is placed at periumbilical area; B, a 5 mm trocars are placed at the “left MacBurney”; C, a 5 mm trocars are placed at the “right MacBurney”; and D, a 5 cm trocar is placed above synchondroses pubis in the middle line.
Fig. 4
Fig. 4. The exposed surgical field of para-aortic lymph nodes: A, right ovarian vein; B, renal vein; C, inferior mesenteric artery; and D, suspended retroperitoneum.
See this image and copyright information in PMC

Comment in

References

    1. Di J, Rutherford S, Chu C. Review of the cervical cancer burden and population-based cervical cancer screening in China. Asian Pac J Cancer Prev. 2015;16:7401–7407. - PubMed
    1. Shah M, Lewin SN, Deutsch I, Burke WM, Sun X, Herzog TJ, et al. Therapeutic role of lymphadenectomy for cervical cancer. Cancer. 2011;117:310–317. - PubMed
    1. Querleu D, Morrow CP. Classification of radical hysterectomy. Lancet Oncol. 2008;9:297–303. - PubMed
    1. Li D, Cai J, Kuang Y, Cao J, Wang Z. Surgical-pathologic risk factors of pelvic lymph node metastasis in stage Ib1–IIb cervical cancer. Acta Obstet Gynecol Scand. 2012;91:802–809. - PubMed
    1. Dargent D, Ansquer Y, Mathevet P. Technical development and results of left extraperitoneal laparoscopic paraaortic lymphadenectomy for cervical cancer. Gynecol Oncol. 2000;77:87–92. - PubMed