Introduction/Background Cyto-reduction of para-aortic lymph nodes refers to the surgical removal or reduction of abnormal or cancerous cells in the lymph nodes located in the para-aortic region.

The main objective in performing that procedure is to increase the disease-free survival and the overall survival in selected patients with gynecological cancer.

There is some controversy in the surgical approach, especially in the treatment of advanced ovarian cancer or its recurrence as well as in cervical cancer.

We propose that robotic-assisted surgery could help us perform this type of surgeries with good postoperative and oncological results.

Methodology We are carefully selecting patients with gynecological cancer (endometrial, ovarian, and cervical cancer) who have para-aortic lymph node involvement and are considerate candidates for a laparoscopic robotic-assisted approach.

Results In this video we present some cases of women with involvement of para-aortic lymph nodes due to gynecological cancer, demonstrating the benefits of a robotic-assisted surgery. These benefits include greater precision in movements, avoiding surgeons’ hand tremors, immersion in a nearby surgical field, and a complete, high-quality view of the small surgical area being treated.

Also shown in the video is the occurrence of a vascular complication and how to approach its repair.

Conclusion Cyto-reduction of para-aortic lymph nodes performed by robotic-assisted surgery is feasible and should be considered in selected patients.

The advantage over open surgery is that we achieve a shorter hospital stay, better postoperative recovery, and it allows for an earlier start of adjuvant treatment.

Disclosures No conflict of interest.