Role of a Double Docking to Improve Lymph Node Dissection: When Robotically Assisted Laparoscopy for Para-aortic Lymphadenectomy Is Associated to a Pelvic Procedure

Abstract

We compare 2 techniques to realize robotic assisted para-aortic lymphadenectomy combined with pelvic procedure. Double docking seems to improve histological results compared to single docking.

Robotic infrarenal paraaortic and pelvic nodal staging for endometrial cancer: feasibility and lymphatic complications

“…In our opinion this is adequate, considering that other studies on robotic infrarenal paraaortic LND in EC or different gynecological malignancies with 5-97 patients report a mean number of 13-31.6 retrieved pelvic and 4.5-25.5 paraaortic lymph nodes (13,(19)(20)(21)(22)(23). In a retrospective study in 41 patients in which it is unclear whether an intention-to-treat policy was applied, Frank e observed that double docking was favorable for infrarenal LND, but with the double docking procedure the a lymph node count was comparable to our single docking procedure in spite of the operative time being 126 min longer (24). In traditional laparoscopy, a lymph node yield of 17.4-22 pelvic and 2.5-12 paraaortic nodes has been reported (25)(26)(27)(28)(29).…”

The role of robotic aortic lymphadenectomy in gynecological cancer: surgical and oncological outcome in a single institution experience

“…To our knowledge, this represents one of the largest series analyzing surgical outcomes and postoperative morbidity of robotic transperitoneal surgery for staging in gynecological cancer patients undergoing aortic lymphadenectomy 25,28,29,[32][33][34][35][36][37] (Table 5). Systematic aortic lymphadenectomy was performed in all cases using a single-docking approach.…”

“…The main characteristics of robotic technology that facilitate surgical performances also help to shorten the learning curve, including three‐dimensional visualization, articulated instrumentation, and stability of the camera . In addition, further technological improvements have improved the versatility of its use, and robotic‐assisted laparoscopy is now a valid and diffused surgical method for treatment of gynecological cancers, even when para‐aortic lymphadenectomy is required …”

“…19 In addition, further technological improvements have improved the versatility of its use, and robotic-assisted laparoscopy is now a valid and diffused surgical method for treatment of gynecological cancers, even when para-aortic lymphadenectomy is required. [20][21][22][23][24][25][26][27][28][29][30] In this context, we investigated the surgical outcome of the robotic approach in gynecological cancer patients undergoing pelvic surgery and aortic lymphadenectomy. All patients provided a written informed consent for their data to be collected and analyzed for scientific purpose, according to our institutional policy.…”

Comparison of Robotic-Assisted vs. Conventional Laparoscopy for Para-aortic Lymphadenectomy in Gynecological Malignancies: A Systematic Review and Meta-Analysis

“…Para-aortic lymphadenectomy (PAL) is an important step in the surgical staging of a variety of gynecologic malignancies, such as cervical, endometrial, and ovarian cancers ( 1 – 3 ). It may provide significant information on the spread of cancer and the prognosis, and help in developing targeted primary and adjuvant therapy ( 4 ).…”