Laparoscopic pelvic lymphadenectomy

Eleven male patients with pelvic malignancy underwent laparoscopic lymphadenectomy for staging of their tumors. The technique allowed removal of pelvic lymph nodes in all 11 patients and metastatic disease was found in five cases, resulting in a change of recommended therapy. The technique was via a three-port exposure, although a fourth suprapubic port was occasionally used for additional retraction. A bladder laceration, which was repaired laparoscopically, was the only intraoperative complication. A pelvic hematoma was the only significant postoperative complication. Laparoscopic pelvic lymphadenectomy appears to offer a less morbid staging for those patients with a high likelihood of nodal metastasis. Laparoscopic detection of positive pelvic lymph nodes may alter the management of genitourinary malignancy and improve overall patient care.