Article Text

Download PDFPDF
Single-Port Laparoscopic Pelvic and Para-Aortic Lymph Node Sampling or Lymphadenectomy: Development of a Technique and Instrumentation
  1. Pedro F. Escobar, MD*,
  2. Amanda Nickles Fader, MD,
  3. Nabila Rasool, MD* and
  4. Luis Rojas Espalliat, MD
  1. *Department of OB/GYN and Women's Health Institute, Section of Gynecologic Oncology, Cleveland Clinic, Cleveland, OH;
  2. Department of Obstetrics and Gynecology, Section of Gynecologic Oncology, Greater Baltimore Medical Center and Johns Hopkins Medical Institutions, Baltimore, MD; and
  3. Avera Mckenna Cancer Center, Sioux Falls, SD.
  1. Address correspondence and reprint requests to Pedro F. Escobar, MD, Section of Gynecologic Oncology, Cleveland Clinic, Desk A-81, 9500 Euclid Ave, Cleveland, OH 44195. E-mail: escobap{at}ccf.org.

Abstract

Background and Objectives: Innovations in minimally invasive surgery have allowed surgeons to perform increasingly complex surgeries through smaller incisions. We describe the feasibility and the technique of single-port laparoscopic pelvic and para-aortic lymph node sampling or lymphadenectomy in gynecologic malignancies.

Methods: The study was approved by the institutional review board at the Cleveland Clinic (Cleveland, Ohio). Inclusion criterion was patients with apparent early-stage gynecologic malignancies who required pelvic and/or para-aortic lymph node sampling or lymphadenectomy and were candidates for single-port laparoscopy. Procedures were performed through a single 2.0- to 3.0-cm umbilical incision using a single-port device, deflecting-tip laparoscope, and multifunctional instrumentation.

Results: Twenty-one patients underwent single-port surgery/staging performed during the study period. The median patient age was 58 years (range, 17-80 years), and the median patient body mass index was 30 mg/kg2 (range, 19-46 mg/kg2). Median overall operating time was 120 minutes (range, 60-185 minutes). Median pelvic and para-aortic node counts were 14 (range, 7-19) and 6 (range, 2-14), respectively.

Conclusions: In this preliminary report, the technique was feasible, and no morbidity was noted. Further studies are needed to better define the ideal gynecologic oncology procedures for single-site surgery and to assess the relative benefits of this new technique compared with more conventional minimally invasive approaches.

  • Single-site surgery
  • Single-port laparoscopy

Statistics from Altmetric.com

Footnotes

  • Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (www.ijgc.com).

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.