Standardized Step-by-step Technique Using Surgical Landmarks in Robotic Lateral Pelvic Lymph Node Dissection

We aimed to show that a standardized step-by-step robotic approach using surgical landmarks could make lateral pelvic lymph node dissection (LPND) less complicated. We performed robot-assisted LPND consisting of 4 steps using surgical landmarks. The first step is a dissection of uretero-hypogastric...

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Bibliographic Details
Published in:Annals of coloproctology 2021, 37(1), , pp.58-60
Main Authors: Bae, Jung Hoon, Koh, Wooree, Kim, Hyun Ho, Lee, Yoon Suk
Format: Article
Language:English
Subjects:
lateral pelvic lymph node dissection
rectal neoplasms
robotic surgical procedures
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Summary:We aimed to show that a standardized step-by-step robotic approach using surgical landmarks could make lateral pelvic lymph node dissection (LPND) less complicated. We performed robot-assisted LPND consisting of 4 steps using surgical landmarks. The first step is a dissection of uretero-hypogastric fascia, which envelopes the ureter and the hypogastric nerve. The second step is a dissection of the medial side of the external iliac vein located at the lateral border of the obturator lymph nodes (LNs) group. The third step is a dissection of the vesico-hypogastric fascia, which is at the medial border of the obturator LNs group. The final step is a dissection of the internal iliac artery until the Alcock's canal. Indocyanine green was injected just before surgery around the dentate line to identify the lateral pelvic LNs. Standardization using a robotic approach for LPND guided by surgical landmarks allows a safer and more effective surgery.
ISSN:2287-9714
2287-9722
DOI:10.3393/ac.2020.08.05