Post-Chemotherapy Robotic Retroperitoneal Lymph Node Dissection: Institutional Experience

Kamel, Mohamed H.; Littlejohn, Nathan; Cox, Michelle B.; Eltahawy, Ehab; Davis, Rodney

doi:10.1089/end.2015.0673

Cited by 40 publications

(33 citation statements)

References 22 publications

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“…There are only a few studies, which reported experience of RA-RPLND for postchemotherapy residual mass. [ 7 16 17 18 ] Although these are retrospective studies and had small number of patients, they reported acceptable surgical and oncologic outcome. Our study of 13 patients is the largest one to best of our knowledge with retrospective and prospective follow-up.…”

Section: Discussionmentioning

confidence: 99%

Robot-assisted retroperitoneal lymph node dissection: Feasibility and outcome in postchemotherapy residual mass in testicular cancer

et al. 2017

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Introduction:We aimed to evaluate the surgical feasibility, complication, and oncological outcome of robot-assisted retroperitoneal lymph node dissection (RA-RPLND) in patients of testicular tumor with postchemotherapy residual retroperitoneal mass.Methods:A total of 13 patients underwent RA-RPLND between January 2012 and September 2016 at our institute. A study was started on December 2015, so data were collected retrospectively and prospectively regarding patient demography, tumor characteristics, surgical, pathological outcome, and oncological outcome.Results:RA-RPLND was successfully completed in all the 13 patients. Lateral approach was used in initial 12 patients with unilateral dissection in 11 patients and bilateral dissection after in 1 patient after repositioning in bilateral position. Supine robotic approach used in 1 patient. Median operative time was 200 min, median estimated blood loss was 120 ml, and median length of hospital stay was 4 days. The median yield of lymph node was 20. Three patients had positive lymph nodes, all had teratoma germ cell tumor. Ten patients had only necrosis in lymph nodes. After median follow-up 23 months (range 3-58 months), no systemic or retroperitoneal recurrence was found. Four patients developed chyle leak. One patient was managed conservatively with diet modification, one with intranodal lipiodol lymphangiography and two patients were managed surgically.Conclusion:RA-RPLND is safe and feasible for postchemotherapy residual mass with accepted compilation rate, but larger studies are required to establish its diagnostic and therapeutic utility along with safety of the procedure.

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Section: Discussionmentioning

confidence: 99%

Robot-assisted retroperitoneal lymph node dissection: Feasibility and outcome in postchemotherapy residual mass in testicular cancer

et al. 2017

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“…Based on the favorable outcomes of L-RPLND in the postchemotherapy setting [ 42 ], the natural evolution of the R-RPLND has included attempts by experienced robotic surgeons to perform postchemotherapy R-RPLND (PC-RPLND) in selected patients. To date, only two smaller series have demonstrated early feasibility [ 12 , 32 ]. The Mayo Clinic R-RPLND experience included nine patients who were postchemotherapy.…”

Section: Postchemotherapy Rplndmentioning

confidence: 99%

“…The advantages of R-RPLND over L-RPLND were similar to other urologic operations that transitioned to a robotic approach: a reduced learning curve, three-dimensional visualization, and greater instrument dexterity from the wristed instruments. Boosted by early results demonstrating equivalence in oncologic and safety measures compared to open and laparoscopic approaches, the R-RPLND has become an excellent option for the treatment of CS I and CS II nonseminomatous GST (NSGCT) and is emerging as a feasible approach for postchemotherapy RPLND [ 12 ]. In this article, we will review the technique and early outcomes of R-RPLND as compared to both O-RPLND and L-RPLND for the management of primary low-stage nonseminomatous and postchemotherapy GCT.…”

Section: Introductionmentioning

confidence: 99%

A Review of Outcomes and Technique for the Robotic-Assisted Laparoscopic Retroperitoneal Lymph Node Dissection for Testicular Cancer

Schwen

Gupta

Pierorazio

2018

Advances in Urology

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Objectives The robotic-assisted laparoscopic retroperitoneal lymph node dissection (R-RPLND) represents a new frontier in the surgical management of testicular cancer in the realm of minimally invasive urologic oncology. We aimed to review the early outcomes as compared to the laparoscopic and open approaches as well as describe the operative technique for the R-RPLND. Materials and Methods We reviewed all the literature related to the R-RPLND based on an electronic PubMed search up until July 2017. Results and Discussion Encouraged by favorable early oncologic and safety outcomes for treatment of clinical stage (CS) I nonseminomatous germ cell tumor (NSGCT), the R-RPLND affords the same recovery advantages as the laparoscopic retroperitoneal lymph node dissection (L-RPLND) while offering greater dexterity, superior visualization, and a theoretically shorter learning curve for the surgeon. While R-RPLND has a promising future in the management of patients with primary and postchemotherapy NSGCT, larger and more vigorous prospective studies are needed before supplanting the open RPLND as the gold standard approach for primary low-stage NSGCT or becoming an equivalent surgical modality in the postchemotherapy setting.

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“…Most of these cases were related to primary RPLND, whereas other investigations were related to salvage RPLND for residual tumor following chemotherapy [12,13,14]. Different patient positions and port configurations have been described, with different indications, advantages and disadvantages.…”

Section: Introductionmentioning

confidence: 99%

Robotic Retroperitoneal Lymph Node Dissection in Advanced Stage Disease

Mearini

Nunzi²,

Biase³

et al. 2016

Urol Int

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Objectives: The current report describes the feasibility of robotic retroperitoneal lymph node dissection (RRPLND), including some technical tricks for port placement for both right- and left-sided surgery. Methods: Patients with advanced stage retroperitoneal disease underwent RRPLND using the 4-arm da Vinci Si Surgical System (Intuitive Surgical, Inc.). In both cases, the field of dissection was an ipsilateral template for lymph node dissection. Results: RRPLND in such configuration was safe and effective in both cases. The illustrated port placement with perpendicular docking of the robot allowed for a wide range of motion with limited external clashing, providing sufﬁcient space for the assistant surgeon. The operative time was 300 min (including docking and console time), with no perioperative complications and short hospital stay. Conclusion: The port configuration for right- or left-sided unilateral template RRPLND was feasible, permitting a wide range of motion for the robotic arms and thus facilitating an efficient and safe dissection.

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Post-Chemotherapy Robotic Retroperitoneal Lymph Node Dissection: Institutional Experience

Abstract: Robotic PC-retroperitoneal lymph node dissection (RPLND) is technically feasible and with acceptable morbidity. It is associated with low blood loss and short hospital stay. More research is needed to assess the long-term outcome and to compare standard open RPLND.

Cited by 40 publications

References 22 publications

Robot-assisted retroperitoneal lymph node dissection: Feasibility and outcome in postchemotherapy residual mass in testicular cancer

Robot-assisted retroperitoneal lymph node dissection: Feasibility and outcome in postchemotherapy residual mass in testicular cancer

A Review of Outcomes and Technique for the Robotic-Assisted Laparoscopic Retroperitoneal Lymph Node Dissection for Testicular Cancer

Robotic Retroperitoneal Lymph Node Dissection in Advanced Stage Disease

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