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#972 Robotic retroperitoneal lumbal limphadenectomy
  1. Vladimir Alexandrovich Alimov1,
  2. Dmitriy Nikolaevich Grekov1,
  3. Alla Vladimirovna Sazhina1,
  4. Liana Nazimovna Aminova2,
  5. Anna Gennadevna Kozub2 and
  6. Olga Sergeevna Alimova2
  1. 1Botkin Hospatal, Moscow, Russia
  2. 2Hadassah Hospatal, Moscow, Russia


Introduction/Background A full-fledged alternative to laparotomy and laparoscopy for performing lumbar lymphadenectomy for cancer of the uterine body is retroperitoneal robotic access. This technique provides an optimal angle of direction of instruments to the area of para-aortic and paracaval lymph nodes, especially this access is convenient in patients with obesity, as well as in the case of local recurrence of tumors in the lumbar lymph nodes after previous operations.

Methodology Carbon dioxide was insufflated retroperitoneally until a pressure of 14 mm Hg was reached. The first anatomical landmarks were the common iliac artery and the ureter. The dissection was carried out between the fasciae of Toldi and Gerota. Further, the ureter is separated from the surrounding tissues. The duodenum is retracted. The left renal vein is exposed. Lymphadenectomy begins. At the same time, there are no anatomically significant formations on the lateral side. On the medial side, damage to the lumbar vessels that depart from the aorta is dangerous.

Results Currently, 10 such operations have been performed in our team. The lengthening of the operating time up to 240–360 minutes was recorded in comparison with the laparoscopic retroperitoneal approach (180–300 minutes). Complications did not occur, blood loss was minimal. At the same time, better visualization in the robotic group and comfortable surgical conditions made it possible for surgeons to be less tired in terms of subjective sensations.

Conclusion Perhaps with the subsequent use of this access, the operation time will decrease, which will allow you to continue to perform these operations no less carefully, but more quickly. And the fatigue of the surgical team is an important factor in the safety of the workflow, which can be improved through robotic surgery.

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