Abstract
There have been no previous reports of post-chemotherapy robotic bilateral retroperitoneal lymph node dissection (RPLND) using a single-dock technique. One deterrent of robotic RPLND is that accessing bilateral retroperitoneal spaces requires patient reposition and surgical robot redocking, therefore increasing operative time. Herein we provide the first step-by-step description of a single-dock technique for robotic bilateral RPLND in the post-chemotherapy setting. We describe port placement and technique for robot positioning to optimize access to bilateral retroperitoneal spaces with a single dock. We also demonstrate the feasibility of sparing the inferior mesenteric artery when utilizing this approach. This single-dock approach was used on two patients at our institution who had residual paracaval masses following chemotherapy for metastatic testicular cancer. Mean operative time was 6 h, and neither patient had significant blood loss or suffered from any peri-operative complications.
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Alvin C. Goh is a proctor for Intuitive Surgical. Samit D. Soni, and Thomas E. Stout declare that they have no conflict of interest.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Informed consent was obtained from all individual participants included in the study.
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11701_2016_622_MOESM1_ESM.mp4
Video 1. Step-by-step instruction for single-dock robotic bilateral RPLND and initial peri-operative outcomes (MP4 122117 kb)
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Stout, T.E., Soni, S.D. & Goh, A.C. Post-chemotherapy robotic bilateral retroperitoneal lymph node dissection using a novel single-dock technique. J Robotic Surg 10, 353–356 (2016). https://doi.org/10.1007/s11701-016-0622-8
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DOI: https://doi.org/10.1007/s11701-016-0622-8