Robot-Assisted Retroperitoneal Lymphadenectomy in Testicular Cancer Treatment: A Systematic Review

Tselos, Aggelos; Moris, Demetrios; Tsilimigras, Diamantis I.; Fragkiadis, Evangelos; Mpaili, Eustratia; Sakarellos, Panagiotis; Vailas, Michail; Shah, Kevin N.; Papalampros, Alexandros

doi:10.1089/lap.2017.0672

Cited by 25 publications

(13 citation statements)

References 35 publications

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“…An important benefit of minimally invasive surgery is the improved perioperative outcome, compared to open surgery [8,9,[26][27][28]. Robot-assisted surgery has additional benefits such as 360° movement of instruments, ability of three dimensional vision, better surgeon ergonomics, and accuracy and stability in confined spaces [21,29]. The only major complication in our series was a lymphocele requiring drainage.…”

Section: Discussionmentioning

confidence: 79%

“…These promising findings are supported by a recent systematic review, which found a weighted average retroperitoneal relapse rate of minimally invasive PC-RPLND of only 1.7% [10]. For RA-PC-RPLND specifically, the data on oncological safety are not yet mature enough to draw firm conclusions [10,21]. In the largest cohort to date, Li et al retrospectively analyzed the outcome of 30 patients undergoing template-based RA-PC-RPLND and compared this with a cohort of patients treated with open resection [11].…”

Section: Discussionmentioning

confidence: 95%

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Clinical outcome of robot-assisted residual mass resection in metastatic nonseminomatous germ cell tumor

et al. 2020

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Purpose To evaluate the outcome of robot-assisted residual mass resection (RA-RMR) in nonseminomatous germ cell tumor (NSGCT) patients with residual tumor following chemotherapy. Patients and methods Retrospective medical chart analysis of all patients with NSGCT undergoing RA-RMR at two tertiary referral centers between January 2007 and April 2019. Patients were considered for RA-RMR in case of a residual tumor between 10 and 50 mm at cross-sectional computed tomography (CT) imaging located ventrally or laterally from the aorta or vena cava, with normalized tumor markers following completion of chemotherapy, and no history of retroperitoneal surgery. Results A total of 45 patients were included in the analysis. The Royal Marsden stage before chemotherapy was IIA in 13 (28.9%), IIB in 16 (35.6%), IIC in 3 (6.7%) and IV in 13 patients (28.9%). The median residual tumor size was 1.9 cm (interquartile range [IQR] 1.4–2.8; range 1.0–5.0). Five procedures (11.1%) were converted to an open procedure due to a vascular injury (n = 2), technical difficulty (n = 2) or tumor debris leakage (n = 1). A postoperative adverse event occurred in two patients (4.4%). Histopathology showed teratoma, necrosis and viable cancer in 29 (64.4%), 14 (31.1%), and two patients (4.4%), respectively. After a median follow-up of 41 months (IQR 22–70), one patient (2.2%) relapsed in the retroperitoneum. The one- and 2-year recurrence-free survival rate was 98%. Conclusion RA-RMR is an appropriate treatment option in selected patients, potentially providing excellent cure rates with minimal morbidity. Long-term outcome data are needed to further support this strategy and determine inclusion and exclusion criteria.

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 95%

Clinical outcome of robot-assisted residual mass resection in metastatic nonseminomatous germ cell tumor

et al. 2020

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“…In the thoracic cage, the robotic-assisted sympathetic trunk has shown its feasibility and the outcome is satisfied, however there are still some procedures worthy to develop, such as intercostal nerve and phrenic nerve intervention, or thoracic outlet decompression by removing the first rib. In the retroperitoneum, robotic-assisted nephrectomy/ lymphadenectomy, hysterectomy and lumbar sympathectomy are widely reported, 13,45,46 however, robotic-assisted nerve surgery is still rare. Many studies discussed nerve-sparing techniques in robotic-assisted prostatectomy, however, robotic nerve intervention was rarely studied, such as pudendal nerve reconstruction after oncological resection, or complicated neurogenic tumor excision.…”

Section: Brachial Plexus Reconstructionmentioning

confidence: 99%

Robotic-Assisted Peripheral Nerve Surgery: A Systematic Review

Chen

Goh

Goh³

et al. 2021

J Reconstr Microsurg

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Background Robotic-assisted techniques are a tremendous revolution in modern surgery, and the advantages and indications were well discussed in different specialties. However, the use of robotic technique in plastic and reconstructive surgery is still very limited, especially in the field of peripheral nerve reconstruction. This study aims to identify current clinical applications for peripheral nerve reconstruction, and to evaluate the advantages and disadvantages to establish potential uses in the future. Methods A review was conducted in the literatures from PubMed focusing on currently published robotic peripheral nerve intervention techniques. Eligible studies included related animal model, cadaveric and human studies. Reviews on robotic microsurgical technique unrelated to peripheral nerve intervention and non-English articles were excluded. The differences of wound assessment and nerve management between robotic-assisted and conventional approach were compared. Results Total 19 studies including preclinical experimental researches and clinical reports were listed and classified into brachial plexus reconstruction, peripheral nerve tumors management, peripheral nerve decompression or repair, peripheral nerve harvesting, and sympathetic trunk reconstruction. There were three animal studies, four cadaveric studies, eight clinical series, and four studies demonstrating clinical, animal, or cadaveric studies simultaneously. In total 53 clinical cases, only 20 (37.7%) cases were successfully approached with minimal invasive and intervened robotically; 17 (32.1%) cases underwent conventional approach and the nerves were intervened robotically; 12 (22.6%) cases converted to open approach but still intervened the nerve by robot; and 4 (7.5%) cases failed to approach robotically and converted to open surgery entirely. Conclusion Robotic-assisted surgery is still in the early stage in peripheral nerve surgery. We believe the use of the robotic system in this field will develop to become popular in the future, especially in the fields that need cooperation with other specialties to provide the solutions for challenging circumstances.

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“…To date, there are multiple works published detailing the outcomes and complications of primary R-RPLND (23). We highlight the four largest series so far in Table 1.…”

Section: Primary R-rplndmentioning

confidence: 99%

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

Ray¹,

Pierorazio²,

Allaf³

2020

Transl Androl Urol

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Open retroperitoneal lymph node dissection (RPLND) is the gold standard for surgical management of the retroperitoneum in patients with testicular cancer, and is associated with excellent oncologic outcomes and significant morbidity including length of stay. Minimally invasive RPLND, starting with laparoscopic retroperitoneal lymph node dissection in 1992 and now robotic retroperitoneal lymph node dissection in 2006, endeavor to decrease the morbidity of open RPLND while maintaining excellent oncologic outcomes. This review surveys the literature regarding both primary and post-chemotherapy robotic RPLND, emphasizing that while early outcomes are promising, much work needs to be done before widespread use of this technique is implemented.

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Robot-Assisted Retroperitoneal Lymphadenectomy in Testicular Cancer Treatment: A Systematic Review

Cited by 25 publications

References 35 publications

Clinical outcome of robot-assisted residual mass resection in metastatic nonseminomatous germ cell tumor

Clinical outcome of robot-assisted residual mass resection in metastatic nonseminomatous germ cell tumor

Robotic-Assisted Peripheral Nerve Surgery: A Systematic Review

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

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