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Peng S, Zheng Y, Yang F, Wang K, Chen S, Wang Y. The Transumbilical Laparoendoscopic Single-Site Extraperitoneal Approach for Pelvic and Para-Aortic Lymphadenectomy: A Technique Note and Feasibility Study. Front Surg 2022; 9:863078. [PMID: 35495753 PMCID: PMC9053588 DOI: 10.3389/fsurg.2022.863078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 03/07/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundNowadays, lymphadenectomy could be performed by the transperitoneal or extraperitoneal approach. Nevertheless, each approach has its own advantages and disadvantages. Under these circumstances, we developed a transumbilical laparoendoscopic single-site (TU-LESS) extraperitoneal approach for lymphadenectomy. In this research, the primary goal is to demonstrate the feasibility of the novel approach in systematic lymphadenectomy and present the surgical process step-by-step.MethodsBetween May 2020 and June 2021, patients who had the indications of systematic lymphadenectomy underwent lymphadenectomy via the TU-LESS extraperitoneal approach. This new approach was described in detail, and the clinical characteristics and surgical outcomes were collected and analyzed.ResultsEight patients with gynecological carcinoma were included in the research, including four with high-risk endometrial cancer and four with early-stage ovarian cancer. The TU-LESS extraperitoneal approach for pelvic and para-aortic lymphadenectomy was successfully performed in all patients without conversion. In all, a median of 26.5 pelvic lymph nodes (range 18–35) and 18.0 para-aortic lymph nodes (range 7–43) were retrieved. There was a median of 166.5 min of surgical time (range 123–205). Patients had speedy recoveries without complications. All patients had positive pain responses after surgery, as well as satisfactory cosmetic and body image outcomes.ConclusionOur initial experience showed that it is feasible to perform systematic lymphadenectomy with the TU-LESS extraperitoneal approach. And this new approach may provide a new measure or a beneficial supplement for lymphadenectomy in gynecologic cancer.
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Affiliation(s)
- Shiyi Peng
- Department of Gynecology, West China Second Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Obstetrics, Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, China
| | - Ying Zheng
- Department of Gynecology, West China Second Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Obstetrics, Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, China
- *Correspondence: Ying Zheng
| | - Fan Yang
- Department of Gynecology, West China Second Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Obstetrics, Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, China
| | - Kana Wang
- Department of Gynecology, West China Second Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Obstetrics, Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, China
| | - Sijing Chen
- Department of Gynecology, West China Second Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Obstetrics, Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, China
| | - Yawen Wang
- Department of Obstetrics and Gynecology, Shanxi Bethune Hospital, Taiyuan, China
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Extraperitoneal Lymphadenectomy in the Management of Gynecologic Cancer. CURRENT OBSTETRICS AND GYNECOLOGY REPORTS 2015. [DOI: 10.1007/s13669-015-0124-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Jernigan AM, Auer M, Fader AN, Escobar PF. Minimally invasive surgery in gynecologic oncology: a review of modalities and the literature. ACTA ACUST UNITED AC 2012; 8:239-50. [PMID: 22554172 DOI: 10.2217/whe.12.13] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Minimally invasive surgery is one of the newest and most exciting areas of development in procedural medicine. This field shows tremendous potential to increase therapeutic benefit while minimizing some of the painful or dangerous side effects of surgical interventions. Minimally invasive surgery has strong historic ties to the field of gynecology and has come a long way as technology and techniques have improved. This has increasingly allowed the application of laparoscopy to more complex procedures and the treatment of gynecologic malignancies. Three laparoscopic approaches, traditional laparoscopy, robotic assisted laparoscopy and laparoendoscopic single-site surgery are reviewed here. We discuss the basic approaches to these three laparoscopic techniques, and then review their applications in gynecologic oncology. We also touch on the evidence behind outcomes associated with their use.
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