A comparative analysis of robotic vs laparoscopic retroperitoneal lymph node dissection for testicular cancer

Abstract

ObjectiveTo compare the safety and perioperative outcomes of robotic retroperitoneal lymph node dissection (R-RPLND) vs laparoscopic RPLND (L-RPLND). Patients and MethodsOur Institutional Review Board-approved retrospective testicular cancer registry was queried for patients who underwent a primary unilateral R-RPLND or L-RPLND by a single surgeon for a stage I testicular non-seminomatous germ cell tumour. Groups were compared for differences in baseline and outcome variables. ResultsBetween July 2006 and July 2014, 16 R-RPLND and 21 L-RPLND cases were performed by a single surgeon. Intraand perioperative outcomes including operative time, estimated blood loss, lymph node yield, complicate rate, and ejaculatory status were similar between groups (all P > 0.1). ConclusionsAs an early checkpoint, R-RPLND appears comparable to L-RPLND in terms of safety and perioperative outcomes. It remains unclear if R-RPLND offers any tangible benefits over standard laparoscopy.

Extraperitoneal robot-assisted laparoscopic retroperitoneal lymph node dissection for early-stage testicular nonseminomatous germ cell tumors

“…The first comparative analysis laparoscopic and robotic RPLND examined the perioperative outcomes of 16 and 21 patients who underwent R-RPLND and laparoscopic RPLND respectively. [ 3 ] Intra and perioperative outcomes including operative time, estimated blood loss, lymph node yield, complicate rate, and ejaculatory status were similar between groups (all P > .1). The results show that R-RPLND is at best equivalent to the laparoscopic approach in terms of safety and perioperative outcomes.…”

“…[ 2 ] R-RPLND appears comparable to laparoscopic RPLND in terms of safety and perioperative outcomes. [ 3 ] Typically, R-RPLND has been performed via a transperitoneal approach. We describe a novel R-RPLND using an extraperitoneal approach that to our knowledge has not been previously described in the literature.…”

28-year late spermatic cord relapse of a testicular non-seminomatous germ cell tumour, managed robotically

“…Robotic surgery is being used more broadly in urology and its application now includes RPLND. 16,17 Competing interests: Mr. Hayes declares no competing personal or financial interests. Dr. Jewett has been an Advisory Board member for Novartis, Pfizer, and Theralase; has received grants/honoraria from GSK, Novartis, and Pfizer; holds investments in Theralase; and has participated in clinical trials for GSK, Novartis, and Pfizer.…”

Robot‐assisted retroperitoneal lymph node dissection in testicular cancer

“…Accordingly, this approach was considered by many as a sampling or a staging procedure rather than a complete therapeutic procedure. With the evolution of the technique, more mature series' described a full therapeutic dissection with equivalent oncologic outcomes and less morbidity compared to open RPLND . However, due to the problems with use of adjuvant chemotherapy and lower node counts, this procedure has not diffused throughout the urological oncology community.…”

“…A recent comparative study of laparoscopic and robotic RPLND examined the perioperative outcomes of 16 and 21 patients who underwent RA‐RPLND and LA‐RPLND respectively. Both groups underwent unilateral modified templates and none had previous chemotherapy.…”