AUA Urology Teaching Videos:Robotic-Assisted Extended Lymph Node Dissection for Pelvic Malignancies



AUA Urology Core Curriculum Teaching Videos
Robotic-Assisted Extended Lymph Node Dissection for Pelvic Malignancies
Mehrdad Alemozaffar, MD
Emory University School of Medicine, Department of Urology
Introduction:
The role of lymph node dissection in the staging and treatment of pelvic malignancies such as bladder and prostate has a demonstrated benefit. There remains some controversy regarding the extent of the template and whether a similar dissection can be carried out robotically as compared to an open approach
Details on Techniques:
In the following video we demonstrate a robotic assisted extended pelvic lymph node dissection up to the level of the peri-aortic and para-caval packets also bilaterally including the obturator, common and external iliac, pre-siatic lymph nodes, and presacral lymph nodes.
Results:
Mean lymph node yield was 38.5. 14 patients (19.4%) had positive lymph nodes with a mean number of 3.7 nodes positive. Table 1 summarizes the lymph node yield and positivity per each of the packets listed above.
Conclusions:
A thorough pelvic lymph node dissection is feasible robotically as high as the peri-aortic and para-caval lymph node packets. The extent of the lymph node template and therapeutic benefits remain somewhat controversial.

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