Aera Yoon1, Ha-Na Yoo2, Yoo-Young Lee2, Jeong-Won Lee2, Byoung-Gie Kim2, Duk-Soo Bae2, Tae-Joong Kim1. 1. Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. Electronic address: tj28.kim@gmail.com. 2. Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Abstract
STUDY OBJECTIVE: To report the feasibility of performing robotic single-port surgery including pelvic lymphadenectomy in endometrial cancer. DESIGN: Canadian Task Force III. PATIENT: A 49-year-old, multiparous patient diagnosed with well-differentiated Fédération Internationale de Gynécologie et d'Obstétrique stage I endometrioid adenocarcinoma. SETTING: The patient underwent robotic single-port peritoneal washing, total hysterectomy, bilateral adnexectomy, and pelvic lymphadenectomy. The procedure was performed using the da Vinci Si Surgical System (Intuitive Surgical, Sunnyvale, CA) through a single 2.5-cm umbilical incision. We used a 5-lumen port for single-site instruments, a 3-dimensional high-definition 8.5-mm endoscope, a 5-mm accessory port, and insufflation channel. Monopolar cautery and a bipolar Maryland dissector were used for lymphadenectomy. Vaginal cuff closure was performed using a needle driver and Maryland dissector with V-lock suture. Near the end of the surgery, the 5-mm assistant port was changed with a 10-mm-sized port. Then, a dissected lymph node in an endobag and a needle used in vaginal cuff closure were removed through the 10-mm port. INTERVENTIONS: Total hysterectomy and bilateral adnexectomy with pelvic lymphadenectomy were performed using robotic single-site platform. MEASUREMENTS AND MAIN RESULTS: The total operative time was 206 minutes. The total vaginal cuff closure time was 22 minutes, and lymphadenectomy took 48 minutes. The estimated blood loss was 100 mL; no intraoperative and postoperative complications occurred. The total number of excised lymph nodes was 11. CONCLUSION: Robotic single-port pelvic lymphadenectomy is feasible. Further studies should be performed to assess the benefits of this procedure.
STUDY OBJECTIVE: To report the feasibility of performing robotic single-port surgery including pelvic lymphadenectomy in endometrial cancer. DESIGN: Canadian Task Force III. PATIENT: A 49-year-old, multiparous patient diagnosed with well-differentiated Fédération Internationale de Gynécologie et d'Obstétrique stage I endometrioid adenocarcinoma. SETTING: The patient underwent robotic single-port peritoneal washing, total hysterectomy, bilateral adnexectomy, and pelvic lymphadenectomy. The procedure was performed using the da Vinci Si Surgical System (Intuitive Surgical, Sunnyvale, CA) through a single 2.5-cm umbilical incision. We used a 5-lumen port for single-site instruments, a 3-dimensional high-definition 8.5-mm endoscope, a 5-mm accessory port, and insufflation channel. Monopolar cautery and a bipolar Maryland dissector were used for lymphadenectomy. Vaginal cuff closure was performed using a needle driver and Maryland dissector with V-lock suture. Near the end of the surgery, the 5-mm assistant port was changed with a 10-mm-sized port. Then, a dissected lymph node in an endobag and a needle used in vaginal cuff closure were removed through the 10-mm port. INTERVENTIONS: Total hysterectomy and bilateral adnexectomy with pelvic lymphadenectomy were performed using robotic single-site platform. MEASUREMENTS AND MAIN RESULTS: The total operative time was 206 minutes. The total vaginal cuff closure time was 22 minutes, and lymphadenectomy took 48 minutes. The estimated blood loss was 100 mL; no intraoperative and postoperative complications occurred. The total number of excised lymph nodes was 11. CONCLUSION: Robotic single-port pelvic lymphadenectomy is feasible. Further studies should be performed to assess the benefits of this procedure.
Authors: Nicole Concin; Carien L Creutzberg; Ignace Vergote; David Cibula; Mansoor Raza Mirza; Simone Marnitz; Jonathan A Ledermann; Tjalling Bosse; Cyrus Chargari; Anna Fagotti; Christina Fotopoulou; Antonio González-Martín; Sigurd F Lax; Domenica Lorusso; Christian Marth; Philippe Morice; Remi A Nout; Dearbhaile E O'Donnell; Denis Querleu; Maria Rosaria Raspollini; Jalid Sehouli; Alina E Sturdza; Alexandra Taylor; Anneke M Westermann; Pauline Wimberger; Nicoletta Colombo; François Planchamp; Xavier Matias-Guiu Journal: Virchows Arch Date: 2021-02 Impact factor: 4.064