Robotic Systematic Portal Lymphadenectomy. Description of Surgical Technique

Portal lymphadenectomy is an integral part of gallbladder, intrahepatic cholangiocarcinoma, and perihilar cholangiocarcinoma resection to improve staging and prognostication. This is also believed by many oncologists to potentially serve as therapy to remove cancer containing nodes. While the current guideline requires removal of at least 6 portal lymphnodes, many surgeons face technical difficulty in performing the systematic portal lymphadenectomy especially in minimally invasive fashion. The anatomical complexity of biliovascular structures within the porta hepatis contributes to this technical challenge. In this video, we demonstrate our robotic technique of systematic portal lymphadenectomy for the treatment of gallbladder cancer.