EP625\u2005Laparoscopic transperitoneal para-aortic lymphadenectomy

Abstract

Introduction/Background Lymphadenectomy in gynaecologic cancer has been traditionally performed by laparotomy. However, in recent decades, the laparoscopic approach has been associated with fewer postoperative complications including less blood loss, minor postoperative adhesion formation, and shorter hospital stay than laparotomy, with an equivalent assessment of lymph node Status. Methodology A 47-year-old, otherwise healthy woman, G2 P1 with BMI of 46 kg/m2, presented with histologically verified endometrioid adenocarcinoma of the endometrium Stage 2 from the International Federation of Gynecology and Obstetrics (FIGO). The Eastern Cooperative Oncology Group (ECOG) performance was 0. We present a surgical film focused on the anatomy of para-aortic retroperitoneal spaces and the surgical technique of transperitoneal para-aortic lymphadenectomy. The standard laparoscopic procedure for surgical staging was carried out. In brief, five trocars were placed at the abdominal wall: one 10-mm trocar at umbilicus and the other 10-mm trocar in at 2 cm above the symphysis pubis. Three 5-mm trocars were punctured right lower abdomen, left lower abdomen and left paraumbillicus. Results The operating time was 78 minutes and the estimated blood loss was 110 mL We removed 19 paraaortic Lymph nodes; None of them was metastatic. There were no postoperative complications. Patient was dismissed after 4 days. Conclusion Laparoscopic transperitoneal access to lumboaortic lymph nodes is an effective method of lymphadenectomy, which may bring benefits to a patient and physician. Laparoscopy is the first choice to perform a para-aortic lymphadenectomy. However, an adequate learning curve and an in-depth knowledge of the retroperitoneal anatomy are highly important for this approach. Disclosure Nothing to disclose.