Skip to main content

Robot-Assisted Pelvic Lymphadenectomy

  • Chapter
  • First Online:
Robotic Surgery of the Bladder
  • 1151 Accesses

Abstract

A robot-assisted technique for radical cystectomy must address all three stages of this technically challenging operation: extirpation of the primary tumor, adequate lymphadenectomy, and a urinary diversion method that satisfies that patient’s needs. In this review chapter, we will focus on the lymph node dissection component and outline the history of its development, its contribution to oncologic outcomes, and a step-by-step detailed description of technique with matching video clips and still images.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Vazina A, Dugi D, Shariat SF, Evans J, Link R, Lerner SP. Stage specific lymph node metastasis mapping in radical cystectomy specimens. J Urol. 2004;171(5):1830–4.

    Article  PubMed  Google Scholar 

  2. Stein JP, Lieskovsky G, Cote R, Groshen S, Feng AC, Boyd S, et al. Radical cystectomy in the treatment of invasive bladder cancer: long-term results in 1,054 patients. J Clin Oncol. 2001;19(3):666–75.

    PubMed  CAS  Google Scholar 

  3. Skinner DG. Management of invasive bladder cancer: a meticulous pelvic node dissection can make a difference. J Urol. 1982;128(1):34–6.

    PubMed  CAS  Google Scholar 

  4. Madersbacher S, Hochreiter W, Burkhard F, Thalmann GN, Danuser H, Markwalder R, et al. Radical cystectomy for bladder cancer today–a homogeneous series without neoadjuvant therapy. J Clin Oncol. 2003;21(4):690–6.

    Article  PubMed  Google Scholar 

  5. Leissner J, Hohenfellner R, ThĂ¼roff JW, Wolf HK. Lymphadenectomy in patients with transitional cell carcinoma of the urinary bladder; significance for staging and prognosis. BJU Int. 2000;85(7):817–23.

    Article  PubMed  CAS  Google Scholar 

  6. Leissner J, Ghoneim MA, Abol-Enein H, ThĂ¼roff JW, Franzaring L, Fisch M, et al. Extended radical lymphadenectomy in patients with urothelial bladder cancer: results of a prospective multicenter study. J Urol. 2004;171(1):139–44.

    Article  PubMed  CAS  Google Scholar 

  7. Herr HW, Bochner BH, Dalbagni G, Donat SM, Reuter VE, Bajorin DF. Impact of the number of lymph nodes retrieved on outcome in patients with muscle invasive bladder cancer. J Urol. 2002;167(3):1295–8.

    Article  PubMed  Google Scholar 

  8. Leadbetter WF, Cooper JF. Regional gland dissection for carcinoma of the bladder, a technique of one-stage cystectomy, gland dissection and bilateral ureteroenterostomy. J Urol. 1950;63:242–60.

    PubMed  CAS  Google Scholar 

  9. Whitmore Jr WF, Marshall VF. Radical total cystectomy for cancer of the bladder: 230 consecutive cases five years later. J Urol. 1962;87:853–68.

    PubMed  Google Scholar 

  10. Dretler SP, Ragsdale BD, Leadbetter WF. The value of pelvic lymphadenectomy in the surgical treatment of bladder cancer. J Urol. 1973;109(3):414–6.

    PubMed  CAS  Google Scholar 

  11. Smith Jr JA, Whitmore Jr WF. Regional lymph node metastasis from bladder cancer. J Urol. 1981;126(5):591–3.

    PubMed  Google Scholar 

  12. Zehnder P, Studer UE, Skinner EC, Dorin RP, Cai J, Roth B, et al. Super extended versus extended pelvic lymph node dissection in patients undergoing radical cystectomy for bladder cancer: a comparative study. J Urol. 2011;186(4):1261–8.

    Article  PubMed  Google Scholar 

  13. Gofrit ON, Stadler WM, Zorn KC, Lin S, Silvestre J, Shalhav AL, et al. Adjuvant chemotherapy in lymph node positive bladder cancer. Urol Oncol. 2009;27(2):160–4.

    Article  PubMed  CAS  Google Scholar 

  14. Stein JP, Cai J, Groshen S, Skinner DG. Risk factors for patients with pelvic lymph node metastases following radical cystectomy with en bloc pelvic lymphadenectomy: concept of lymph node density. J Urol. 2003;170(1):35–41.

    Article  PubMed  Google Scholar 

  15. Stein JP, Penson DF, Cai J, Miranda G, Skinner EC, Dunn MA, et al. Radical cystectomy with extended lymphadenectomy: evaluating separate package versus en bloc submission for node positive bladder cancer. J Urol. 2007;177(3):876–81. discussion 881–2.

    Article  PubMed  Google Scholar 

  16. Bochner BH, Herr HW, Reuter VE. Impact of separate versus en bloc pelvic lymph node dissection on the number of lymph nodes retrieved in cystectomy specimens. J Urol. 2001;166(6):2295–6.

    Article  PubMed  CAS  Google Scholar 

  17. Bochner BH, Cho D, Herr HW, Donat M, Kattan MW, Dalbagni G. Prospectively packaged lymph node dissections with radical cystectomy: evaluation of node count variability and node mapping. J Urol. 2004;172(4 Pt 1):1286–90.

    Article  PubMed  Google Scholar 

  18. Brössner C, Pycha A, Toth A, Mian C, Kuber W. Does extended lymphadenectomy increase the morbidity of radical cystectomy? BJU Int. 2004;93(1):64–6.

    Article  PubMed  Google Scholar 

  19. Hayn MH, Hellenthal NJ, Hussain A, et al. Does previous robot-assisted radical prostatectomy experience affect outcomes of robot-assisted radical cystectomy? Results from the international Robotic Cystectomy Consortium. Urology. 2010;76:1111–6.

    Article  PubMed  Google Scholar 

  20. Bader P, Burkhard FC, Markwalder R, Studer UE. Is a limited lymph node dissection an adequate staging procedure for prostate cancer? J Urol. 2002;168(2):514–8.

    Article  PubMed  Google Scholar 

  21. Bochner BH, Cho D, Herr HW, et al. Prospectively packaged lymph node dissections with radical cystectomy: evaluation of node count variability and node mapping. J Urol. 2004;172:1286.

    Article  PubMed  Google Scholar 

  22. Davis JW, Gaston K, Anderson R, et al. Robot assisted pelvic lymphadenectomy at radical cystectomy: lymph node yield compared with second look open dissection. J Urol. 2011;185:79–84.

    Article  PubMed  Google Scholar 

  23. Castle EP. Robot-assisted ileal conduit. Presented at the Society of Urological Surgeons, May 2012.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to John W. Davis M.D. .

Editor information

Editors and Affiliations

Electronic Supplementary Material

Below is the link to the electronic supplementary material.

Initial setup and exposure for robot-assisted pelvic lymphadenectomy (MP4 8854 kb)

External iliac zone (MP4 34993 kb)

Dissection of common iliac vessels (MP4 68293 kb)

Dissection of hypogastric region (MP4 36659 kb)

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer Science+Business Media New York

About this chapter

Cite this chapter

Gaston, K.E., Davis, J.W. (2014). Robot-Assisted Pelvic Lymphadenectomy. In: Castle, E., Pruthi, R. (eds) Robotic Surgery of the Bladder. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-4906-5_9

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-4906-5_9

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-4905-8

  • Online ISBN: 978-1-4614-4906-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics