Introduction/Background Laparoscopic extraperitoneal approach was introduced since 1995 which was primarily used for the evaluation of aortic metastases in patients with cervical cancer. The main advantages of extraperitoneal approach are allowing the surgeon to focus on the operative field without interference of the bowel, consequently overcoming issues related to obesity, and generating fewer de novo adhesions than the transperitoneal laparoscopic approach. in this abstract we will discuss the application of laparoscopic nerve sparing extraperitoneal lymphadenectomy in a patient with advanced cervical cancer associated with bulky paraaortic lymph node metastasis.

Methodology We applied the left sided laparoscopic nerve sparing extraperitoneal approach for excision of a 5 cm retroperitoneal paraaortic nodal mass for 39 years old female patient with history of Advanced cervical cancer stage IIICr. The decision of surgical removal of this bulky paraaortic nodal mass is to facilitate the effect of the definitive chemoradiotherapy.

Results The excision of paraaortic nodal mass was done effectively through laparoscopic extraperitoneal approach with minimal blood loss no perioperative complication and 1 day hospital stay. The final pathology report reveals infiltration of the nodal mass by the same tumor cells.

Conclusion Laparoscopic extraperitoneal paraaortic lymphadenectomy is feasible, effective, and safe approach and has an added value of nerve sparing option and could be applied for wide range of patients with retroperitoneal nodal metastasis either for nodal staging or biopsy.