Introduction/Background Locally advanced cervical cancer is treated with Radio-chemotherapy and brachytherapy. Therefore; a pre-treatment para-aortic lymph node assessment is important for disease staging and therapeutic implications. Our study aimed to analyze the Tunisian experience of laparoscopic lymphadenectomy for patients with locally advanced cervical cancer.

Methodology We reported 29 patients with locally advanced cervical cancer who underwent laparoscopic lymphadenectomy at our Institute between 2016 and 2022.

Results The mean age was 44 years. Patients were staged IIIC1 in 48.2%, 2.,5% were IIB, 6.9% were IVA, 6.9% IB1, 6.9% IB3 and 2.8% were IIA2. CT scan and MRI showed suspicious pelvic lymph nodes in 65.5% and suspicious para-aortic lymph nodes in 17.9% of cases. All patients underwent para-aortic lymph node dissection after a mean time of 6 days. Our technique was 68.9% Transperitoneal and 31.O1% extraperitoneal. The mean time duration was 2:37Hours. There was no per-operative or postoperative complications. One patient had a blood transfusion The mean time of hospital stay was 2 days. Pathological examination found a mean number of 9Nodes (range 2–22 removed lymph nodes).

There was 32.17% of invaded lymph nodes. sensitivity and specificity were respectively 100% and 83.3%, and VPP was 33.3%. All patients had radiochemotherapy for their cervical cancer.

Conclusion Pre-treatment laparoscopic staging surgery plays an important role in the treatment and the decision of the radiation field. Although imaging modalities are improving, the current gold standard for determining lymph node status is surgical sampling mainly in developing countries with difficult access to PET-CT.