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Minimally invasive extraperitoneal lymphadenectomy: clinical validation of an original technique
1Department of Urology, Gabriel Montpied Hospital, Clermont-Ferrand, France. lguy@chu-clermontferrand.fr
Purpose:
To validate an original technique described for pelvic node dissection.
Patients And Methods:
A series of 192 patients were included in this study. The surgical technique we reported in 1987 is based on the use of a special retractor called the pelvioscope. The incision is the classical MacBurney incision on the right and its equivalent on the left. After the division of the muscles, the peritoneum is mobilized medially, and the pelvioscope is introduced. The node resection is then performed with classical surgical instruments.
Results:
In total; 151 bilateral, 20 unilateral right, and 21 unilateral left node dissections have been performed. In one case, dissection was not possible on both sides, and in two cases, the dissection was not complete on one side (patients previously operated on). The average intraoperative time was 69 minutes for a unilateral procedure and 103 minutes for a bilateral procedure. The mean number of pelvic lymph nodes removed was 5.6 on each side. The overall rate of complications was 7.3%.
Conclusion:
The effectiveness of this minimally invasive surgery is clear, and the morbidity is low.