Introduction/Background The retroperitoneal laparoscopic approach has proved several benefits for excising lymph nodes in the aortocaval space in gynecological cancers, as it allows to avoid intraperitoneal adhesions and bowel manipulation. It is usually performed from the left side since most of the lymph nodes are located left to the aorta. Here we describe the right retroperitoneal laparoscopic approach for excising precaval or interaortocaval lymph nodes in gynecological cancers.

Methodology We present the case of a 66-year-old patient with a previous diagnosis of stage II (FIGO 2009) endometrioid endometrial carcinoma, grade 2, mismatch repair deficiency. After a disease-free period of 20 months, an isolated precaval lymph node recurrence was detected in a PET-CT scan. Debulking surgery was indicated at the Gynecologic Oncology tumor board.

Results We present a surgical video documenting the debulking of a precaval lymph node recurrence in endometrial cancer using the right retroperitoneal laparoscopic approach. The adenomegaly was closely attached to the inferior vena cava, but with meticulous dissection the surgery was oncologically successful, with no perioperative complications.

Conclusion Right retroperitoneal laparoscopic route is a secure approach that offers a more direct access to precaval and interaortocaval nodes, and represents a valuable surgical technique for lymph node recurrences at this level.

Disclosures No disclosures.