Application and research progress of single-port laparoscopy in retroperitoneal lymphadenectomy for gynecologic...

Retroperitoneal lymphadenectomy has been widely used to eradicate locoregional disease, improve staging accuracy, and guide adjuvant therapy in the surgical treatment of gynecologic oncological patients. Although multi-port laparoscopy and open surgery can both effectively achieve retroperitoneal lymph node dissection, they are associated with greater surgical trauma and longer postoperative recovery, particularly in obese patients and those with prior surgical histories. In contrast, single-port laparoscopy is an innovative alternative surgical approach for retroperitoneal lymphadenectomy. This technique can offer potential advantages, such as improved cosmetic outcomes, reduced postoperative pain, faster recovery, and improvements in postoperative quality of life. Nonetheless, single-port laparoscopic retroperitoneal lymphadenectomy remains controversial. This article provides a narrative clinical review of the current evidence on single-port laparoscopy for retroperitoneal lymphadenectomy in gynecologic malignancies and is supplemented by a structured literature review and quantitative synthesis of selected comparative studies. Major concerns include the risk of injury to surrounding organs during difficult dissections, the completeness of lymph node removal, patient survival benefits, appropriate patient selection, and the learning curve. This review summarizes key anatomical considerations, current surgical techniques, and advancements in instrumentation, ongoing technical challenges, and future directions of single-port laparoscopic retroperitoneal lymphadenectomy.