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. 2025 Apr;135(4):700-705.
doi: 10.1111/bju.16670. Epub 2025 Jan 30.

Extraperitoneal single-site robot-assisted radical prostatectomy with extended pelvic lymph node dissection: technique and experience

Yubo Wang  1 , Mingzhao Li  1 , Kai Yao  2 , Zhuyinjun Zong  1 , Yifan Chang  3 , Yongda Liu  1 , Chao Cai  1 , Fadi Mousa Al Kalailah  1 , Shancheng Ren  4 , Guohua Zeng  1 , Di Gu  1
Affiliations

Extraperitoneal single-site robot-assisted radical prostatectomy with extended pelvic lymph node dissection: technique and experience

Yubo Wang et al. BJU Int. 2025 Apr.
No abstract available

Keywords: Lymphocele; extended pelvic lymph node dissection; locally advanced prostate cancer; robot‐assisted radical prostatectomy; single site.

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Figures

Fig. 1
Fig. 1
Preoperative preparation of ESSRARP with ePLND. (A) The patient was positioned in a modified Trendelenburg position. (B) The incision was made above the pubic symphysis. (C) The transverse incision was ~5 cm, with a wound protector. (D) The extraperitoneal working space was created with a dilator. Port installation and trocar placement before (E) and after (F) docking.
Fig. 2
Fig. 2
Actual and virtual schematic diagrams of intraoperative steps (ePLND) and important anatomical structure: (A) Determined the deep circumflex iliac vein. (B) Exposed the genitofemoral nerve and psoas major muscle as the lateral limit. (C) Located the common iliac artery bifurcation as the cranial limit. (D) Dissected the external iliac lymph nodes dissection on the lateral side to pretreat perforator vessels and entered the triangle of Marcille to dissect and expose the cranial side of the obturator nerve. (E) The LNs along the internal iliac vessels and the obturator lymphatic tissue were dissected. (F) The surrounding anatomy was skeletonised and performed fenestration of the peritoneum. CIA, common iliac artery; DCIV, deep circumflex iliac vein; EIA, external iliac artery; EIV, external iliac vein; IIA, internal iliac artery; IIV, internal iliac vein; OA, obturator artery; OV, obturator vein.
Fig. 3
Fig. 3
The operative scope of the ESS approach. (A) Adjusting the working arm angle allows for a wide range of flexible movement of the surgical instrument within a fan‐shaped area for most patients. (B) Repositioning the port and re‐docking the surgical robot for patients with a higher BMI to access lymph nodes at higher positions.
See this image and copyright information in PMC

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References

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