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
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.
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.
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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