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Case Reports
. 2025 May;19(3):230-234.
doi: 10.1097/CU9.0000000000000255. Epub 2024 Jul 30.

Robot-assisted laparoscopic retroperitoneal lymph node dissection in testicular cancer using a single-position supine approach: A case report and literature review

Lei Zhou  1 , Kun Yao  1 , Chao Li  1 , Wei Xiong  1 , Weibin Hou  1 , Bingzhi Wang  1 , Long Xu  2 , Long Wang  1
Affiliations
Case Reports

Robot-assisted laparoscopic retroperitoneal lymph node dissection in testicular cancer using a single-position supine approach: A case report and literature review

Lei Zhou et al. Curr Urol. 2025 May.

Abstract

This case study demonstrates a single-position supine approach for robotic retroperitoneal lymph node dissection (R-RPLDN) for the treatment of nonseminomatous germ cell tumors and residual masses after chemotherapy. We performed a bilateral R-RPLDN in a 33-year-old man with nonseminomatous germ cell tumors and residual postchemotherapy masses. For this approach, the patient was placed in a steep Trendelenburg position, and a 5-port transperitoneal technique was used, with the robot docked so that the arms were oriented cephalad. This approach allowed simultaneous access to both sides of the retroperitoneum, thereby eliminating the need for bilateral lymphadenectomy and patient repositioning. Bilateral R-RPLDN was performed using a single-position supine approach. This versatile approach offers a less invasive, more efficient, and safer solution for removing residual postchemotherapy testicular cancer masses.

Keywords: Nonseminomatous germ cell tumor; Retroperitoneal lymph node dissection; Robotic surgery; Single-position supine approach.

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Conflict of interest statement

CL is an early career editorial board member of Current Urology. This article was accepted after normal external review. The other authors declare that they have no competing financial interests or personal relationships that may have influenced the work reported in this study.

Figures

Figure 1
Figure 1
Computed tomography imaging of multiple retroperitoneal lymphadenopathies (residual mass) after radiotherapy and chemotherapy.
Figure 2
Figure 2
Schematic showing the da Vinci Si robot installation. (A) The da Vinci Robot is positioned beside the head of the patient. (B) The da Vinci Si system port locations.
Figure 3
Figure 3
(A) Imaging of suspension of the bowel for retroperitoneal exposure. (B) Imaging after removal of the right lymph nodes. (C) Imaging after removal of the left lymph nodes. (D) Imaging of the lymph nodes between the abdominal aorta and inferior vena cava. AA = abdominal aorta; IMA = inferior mesenteric artery; IVC = inferior vena cava.
Figure 4
Figure 4
Imaging after removal of lymph nodes. (A) Imaging of the intraoperative complete dissection template. (B) Representation of specimen as per location. AA=Abdominal Aorta; IMA=Inferior Mesenteric Artery; IVC=Inferior Vena Cava; LRV=Left Renal Vein; RRA=Right Renal Artery.
Figure 5
Figure 5
Computed tomography imaging at the 3- and 6-month follow-up.
See this image and copyright information in PMC

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