Primary and post-chemotherapy robotic retroperitoneal lymph node dissection for testicular cancer: a review

Ray, Shagnik; Pierorazio, Phillip M.; Allaf, Mohamad E.

doi:10.21037/tau.2020.02.09

Cited by 17 publications

(13 citation statements)

References 40 publications

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“…Minimally invasive RPLND, starting with laparoscopic RPLND in 1992 and robotic RPLND in 2006, endeavor to decrease the morbidity of open RPLND while maintaining excellent oncologic outcomes. The early outcomes of primary robotic RPLND are promising and comparable to the recurrence-free rates of open (92.5%) and laparoscopic RPLND (95.4%), with no reported retroperitoneal recurrences [89]. Unfortunately, comparisons between techniques are challenging due to the different surgical techniques and adjuvant chemotherapy protocols, as well as the short follow-up time.…”

Section: Robotic Retroperitoneal Lymph Node Dissection (Robotic Rplnd)mentioning

confidence: 90%

Robotics in Urology: No More Shadows?

Luciani

Mattevi

Cai

et al. 2021

Uro

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Robotic surgery saw unprecedented success throughout the world, with urology as a key discipline. Robotic-assisted radical prostatectomy (RARP) and partial nephrectomy (RAPN) were the frontline procedures. Many other urologic procedures have since been standardized over time. However, there is no universal consensus in current research on the recognition of robotics as the standard of care. Although better operative outcomes have been reported for most robotic procedures compared to open and laparoscopic surgery, no superiority has been proven as far as oncologic outcomes are concerned. This review aims to describe current research on robotic surgery concerning each urologic procedure, showing its applications and limits. The non-classic parameters in part responsible for the planetary success of robotics, such as the shorter learning curve, improved ergonomics, and surgeon’s comfort, as well immersive three-dimensional vision, are further areas of focus.

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Section: Robotic Retroperitoneal Lymph Node Dissection (Robotic Rplnd)mentioning

confidence: 90%

Robotics in Urology: No More Shadows?

Luciani

Mattevi

Cai

et al. 2021

Uro

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“…R-RPLND has been performed on all generations of the DaVinci system from Si to SP [13,14,15,16 unilateral and bilateral template dissections. Studies demonstrated successful R-RPLND with lateral and flank positions, as well as extraperitoneal approaches [17,18].…”

Section: Surgical Techniquementioning

confidence: 99%

“…R-RPLND has been performed on all generations of the DaVinci system from Si to SP [13,14,15,16 ▪▪ ]. Our institution utilizes the Xi system, which facilitates single docking and flexibility in performing unilateral and bilateral template dissections.…”

Section: Surgical Techniquementioning

confidence: 99%

Robotic-assisted retroperitoneal lymph node dissection for testicular cancer

Gereta

Hung

2023

Current Opinion in Urology

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Purpose of reviewRobotic-assisted retroperitoneal lymph node dissection (R-RPLND) is an emerging surgical option for testicular cancer with less morbidity than open RPLND. We outline the operative technique used at our center and review contemporary evidence in the advancement of R-RPLND.Recent findings R-RPLND is being applied effectively beyond clinical stage I testicular cancer to treat low-volume, clinical stage II disease in both the primary and postchemotherapy setting. Compared with the open approach, R-RPLND offers shorter hospitalization and less blood loss with comparably low complications and oncologic control.

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“…[6]. The robotic approach has helped to reap the benefits of minimally invasive surgical techniques and has the advantages of a shortened learning curve with improved visualisation, instrument dexterity, and better ergonomics [7–10]. R‐RPLND is an emerging treatment option and there have been several reports on its outcomes.…”

Section: Introductionmentioning

confidence: 99%

Robot‐assisted retroperitoneal lymph node dissection: a systematic review of perioperative outcomes

Garg¹,

Mansour²,

Psutka

et al. 2023

BJU International

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To assess the safety and feasibility of robot-assisted retroperitoneal lymph node dissection (R-RPLND) and to compare the perioperative outcomes of R-RPLND with open RPLND (O-RPLND), as RPLND forms an integral part of the management of testis cancer and R-RPLND is a minimally invasive treatment option for this disease. Materials and MethodsThe PubMed â , Scopus â , Cochrane Central Register of Controlled Trials, and Web of Science TM databases were searched for studies reporting perioperative outcomes of primary and post-chemotherapy R-RPLND and studies comparing R-RPLND with O-RPLND. ResultsThe search yielded 42 articles describing R-RPLND, including five comparative studies. The systematic review included 4222 patients (single-arm studies, n = 459; comparative studies, n = 3763). Of 459 patients in the single-arm studies, 271 underwent primary R-RPLND and 188 underwent post-chemotherapy R-RPLND. For primary R-RPLND, the operative time ranged from 175 to 540 min and the major complication rate was 4.1%. For post-chemotherapy R-RPLND, the operative time ranged from 134 to 550 min and the major complication rate was 8.5%. The conversion rate to open surgery was 2.2% in primary R-RPLND and 9.0% in post-chemotherapy R-RPLND. In comparison with O-RPLND, R-RPLND was associated with a lower transfusion rate (14.5% vs 0.9%, P < 0.001) and a lower complication rate (18.5% vs 7.8%, P = 0.002). ConclusionRobot-assisted RPLND has acceptable perioperative outcomes in both the primary and post-chemotherapy settings but a notable rate of conversion to open surgery in the post-chemotherapy setting. Compared with O-RPLND, R-RPLND is associated with a lower transfusion rate and fewer overall complications. Given the potential impact of selection bias, the optimal patient selection criteria for R-RPLND remain to be elucidated.

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Primary and post-chemotherapy robotic retroperitoneal lymph node dissection for testicular cancer: a review

Cited by 17 publications

References 40 publications

Robotics in Urology: No More Shadows?

Robotics in Urology: No More Shadows?

Robotic-assisted retroperitoneal lymph node dissection for testicular cancer

Robot‐assisted retroperitoneal lymph node dissection: a systematic review of perioperative outcomes

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