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357 Step by step laparoscopic hysterectomy with pelvic and paraaortic lymphadenectomy. Anatomical landmarks
  1. K Nowak,
  2. Z Borowiec,
  3. A Machnicka-Rusek and
  4. E Milnerowicz-Nabzdyk
  1. SPZOZ Opolskie Centrum Onkologii im. prof. Tadeusza Koszarowskiego, Opole, Poland


Introduction/Background*Surgical management of endometrial cancer is initial treatment for most patients and in early stages of disease is usually curative.The first laparoscopic treatment for endometrial cancer was described by Childers in 1993. Since then, indications for laparoscopic surgery are rising. Comprehensive staging of endometrial cancer guides the use of post-operative adjuvant therapy.Benefits of a laparoscopic approach are shorter hospitalisations, lower blood loss, faster postoperative recovery.

Methodology Safe , step by step method of total hysterectomy and bilateral salpingo-oophorectomy with pelvic and para-aortic lymph node dissection. Dissection and visualisation of anatomical landmarks as safest , most reliable method of performing laparoscopic surgery.

Result(s)*54 year old woman with endometrial cancer G2 FIGO IB was qualified for laparoscopic surgery. Total hysterectomy and bilateral salpingo-oophorectomy with pelvic and para-aortic lymph node was performed. Patient was discharged from hospital after 3 days in good condition, with no significant blood loss or other complications.Final histopathology result : TIBN0M0 , 68 lymph nodes from paraaortic and pelvic lyphadectomy.LVSI negative

Conclusion*We are convinced that our approach to laparoscopic total hysterectomy with lymphadenectomy is safe and repetitive. By dissection and visualisation key anatomical landmarks we can avoid complications such as bleeding , damage to the ureters, nerves and vessels.

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