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Updated: Jan 17, 2026

Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer

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Robotic-Assisted Retroperitoneal Lymph Node Dissection in a Challenging Post-Chemotherapy Case.

Willy Baccaglini^1,2,3, Gabriel Chahade Sibanto Simões², Julio Calderón²

¹Departamento de Urologia, Faculdade de Medicina do ABC, Santo André, SP, Brasil.

International Braz J Urol : Official Journal of the Brazilian Society of Urology

|September 15, 2025

Summary

Robotic retroperitoneal lymph node dissection (RPLND) is feasible for large post-chemotherapy testicular cancer masses. This minimally invasive approach offers excellent outcomes and faster recovery in experienced centers.

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Area of Science:

Urology
Surgical Oncology
Minimally Invasive Surgery

Background:

Robotic retroperitoneal lymph node dissection (RPLND) offers a minimally invasive option for testicular germ cell tumors.
Post-chemotherapy residual masses present significant technical challenges for RPLND.

Purpose of the Study:

To present a case of robotic RPLND for a large post-chemotherapy residual mass in a testicular germ cell tumor patient.
To evaluate the feasibility and outcomes of robotic RPLND in a complex clinical scenario.

Main Methods:

A 23-year-old male with a residual interaortocaval mass post-chemotherapy underwent robotic RPLND.
The procedure involved a complete bilateral template dissection using four robotic ports.
En bloc tumor removal was achieved with meticulous dissection and advanced bipolar energy.

Main Results:

The bulky mass was successfully resected in 300 minutes with minimal blood loss (50 mL) and no intraoperative complications.
The patient experienced a rapid recovery, discharged on postoperative day one and resuming activities within two weeks.
At 6-month follow-up, the patient remained disease-free with normal tumor markers and no complications.

Conclusions:

Robotic RPLND is feasible for managing large post-chemotherapy residual masses in testicular cancer.
The robotic platform facilitates precise dissection in challenging cases, leading to favorable outcomes.
Centralized expertise and standardized techniques are crucial for optimal results in robotic RPLND.