Laparoendoscopic single-site retroperitoneal lymph node dissection in non-seminomatous germ cell malignancy

Area of Science:

• Urology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Laparoendoscopic single-site (LESS) surgery provides an alternative to traditional multiport surgery, offering benefits like reduced pain and improved cosmesis.
• Umbilical LESS is applicable to a wide range of urologic procedures.

Observation:

• A 38-year-old male with recurrent stage I nonseminomatous mixed germ cell tumor underwent umbilical retroperitoneal lymph node dissection using a single-site multichannel port.
• The procedure involved mobilizing the colon to access the retroperitoneum for complete lymph node dissection.

Findings:

• The retroperitoneal lymph node dissection (LDRP-LESS) was completed in 85 minutes with minimal bleeding (50 cc).
• The patient experienced a rapid recovery, was discharged the next day without analgesia, and reported high satisfaction with cosmetic results.
• Pathology confirmed metastatic seminoma in 5 of 11 lymph nodes; the patient remained disease-free one year after chemotherapy.

Implications:

• Umbilical primary LDRP-LESS is a viable and minimally invasive surgical option for selected patients with excellent oncologic and cosmetic results.
• This approach may be cost-effective due to the reusable instruments, representing a potentially advantageous surgical strategy.