BACKGROUND: To date, there is still a paucity of data in the literature on robotic-assisted laparoscopic extended pelvic lymph node dissection (RALEPLND) in patients with prostate cancer. OBJECTIVE: To assess the technical feasibility of RALEPLND and to present our surgical technique. DESIGN, SETTING, AND PARTICIPANTS: From April 2006 to March 2008, we performed RALEPLND in 99 patients prior to robotic-assisted laparoscopic radical prostatectomy. Indications for RALEPLND were a prostate-specific antigen (PSA) > or = 10 ng/ml or a preoperative Gleason score > or = 7. The data were evaluated retrospectively. SURGICAL PROCEDURE: The transperitoneal approach was used in all cases. In order to gain optimal access to the common iliac bifurcation, the five trocars were placed in a more cephalad position than in patients undergoing radical prostatectomy without RALEPLND. After identification of important landmarks, the lymphatics covering the external iliac vein, the obturator lymphatic packet, and the lymphatics overlying the internal iliac artery were removed on both sides. MEASUREMENTS: The total lymph node yield, the frequency of lymph node metastases, and the complication rate. RESULTS AND LIMITATIONS: The median patient age was 64 yr (range: 45-78). The median preoperative PSA level was 7.7 ng/ml (range: 1.5-84.6). The median number of lymph nodes harvested was 19 (range: 8-53). In 16 patients (16%), we found lymph node metastasis. Complications occurred in seven patients (7%). CONCLUSIONS: RALEPLND is feasible, and its lymph node yield is well in the range of open series. The robotic-assisted laparoscopic approach in itself does not seem to limit a surgeon's ability to perform a complete extended pelvic lymph node dissection.
BACKGROUND: To date, there is still a paucity of data in the literature on robotic-assisted laparoscopic extended pelvic lymph node dissection (RALEPLND) in patients with prostate cancer. OBJECTIVE: To assess the technical feasibility of RALEPLND and to present our surgical technique. DESIGN, SETTING, AND PARTICIPANTS: From April 2006 to March 2008, we performed RALEPLND in 99 patients prior to robotic-assisted laparoscopic radical prostatectomy. Indications for RALEPLND were a prostate-specific antigen (PSA) > or = 10 ng/ml or a preoperative Gleason score > or = 7. The data were evaluated retrospectively. SURGICAL PROCEDURE: The transperitoneal approach was used in all cases. In order to gain optimal access to the common iliac bifurcation, the five trocars were placed in a more cephalad position than in patients undergoing radical prostatectomy without RALEPLND. After identification of important landmarks, the lymphatics covering the external iliac vein, the obturator lymphatic packet, and the lymphatics overlying the internal iliac artery were removed on both sides. MEASUREMENTS: The total lymph node yield, the frequency of lymph node metastases, and the complication rate. RESULTS AND LIMITATIONS: The median patient age was 64 yr (range: 45-78). The median preoperative PSA level was 7.7 ng/ml (range: 1.5-84.6). The median number of lymph nodes harvested was 19 (range: 8-53). In 16 patients (16%), we found lymph node metastasis. Complications occurred in seven patients (7%). CONCLUSIONS: RALEPLND is feasible, and its lymph node yield is well in the range of open series. The robotic-assisted laparoscopic approach in itself does not seem to limit a surgeon's ability to perform a complete extended pelvic lymph node dissection.
Authors: Etienne Xavier Keller; Jacqueline Bachofner; Anna Jelena Britschgi; Karim Saba; Ashkan Mortezavi; Basil Kaufmann; Christian D Fankhauser; Peter Wild; Tullio Sulser; Thomas Hermanns; Daniel Eberli; Cédric Poyet Journal: World J Urol Date: 2018-12-05 Impact factor: 4.226
Authors: Nicolas Koutlidis; Céline Duperron; Mathilde Funes de la Vega; Eric Mourey; Frédéric Michel; Luc Cormier Journal: World J Urol Date: 2013-10-29 Impact factor: 4.226
Authors: Ashkan Mortezavi; Etienne Xavier Keller; Cédric Poyet; Thomas Hermanns; Karim Saba; Marco Randazzo; Christian Daniel Fankhauser; Peter J Wild; Holger Moch; Tullio Sulser; Daniel Eberli Journal: World J Urol Date: 2016-03-01 Impact factor: 4.226
Authors: Jonathan L Silberstein; Andrew J Vickers; Nicholas E Power; Raul O Parra; Jonathan A Coleman; Rodrigo Pinochet; Karim A Touijer; Peter T Scardino; James A Eastham; Vincent P Laudone Journal: J Endourol Date: 2011-11-08 Impact factor: 2.942
Authors: Andrew H Feifer; Elena B Elkin; William T Lowrance; Brian Denton; Lindsay Jacks; David S Yee; Jonathan A Coleman; Vincent P Laudone; Peter T Scardino; James A Eastham Journal: Cancer Date: 2011-03-15 Impact factor: 6.860
Authors: Daniela A Ferraro; Urs J Muehlematter; Helena I Garcia Schüler; Niels J Rupp; Martin Huellner; Michael Messerli; Jan Hendrik Rüschoff; Edwin E G W Ter Voert; Thomas Hermanns; Irene A Burger Journal: Eur J Nucl Med Mol Imaging Date: 2019-09-14 Impact factor: 9.236