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Obstetrics and Gynecology International
Volume 2013 (2013), Article ID 931318, 8 pages
http://dx.doi.org/10.1155/2013/931318
Clinical Study

Robotic-Assisted Transperitoneal Aortic Lymphadenectomy as Part of Staging Procedure for Gynaecological Malignancies: Single Institution Experience

1Department of Gynecology, Cervical Cancer Center, European Institute of Oncology, Milan 20141, Italy
2Department of Obstetrics and Gynaecology, Ospedale San Bortolo, Vicenza 36010, Italy
3Department of Obstetrics and Gynaecology, Niguarda Ca’ Granda Hospital, Milan 20162, Italy

Received 18 December 2012; Revised 24 May 2013; Accepted 15 June 2013

Academic Editor: Curt W. Burger

Copyright © 2013 V. Zanagnolo et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. This study was designed to confirm the feasibility and safety of robotic-assisted transperitoneal aortic lymphadenectomy as part of staging procedure for gynecologic malignancies. Methods. Chart review of 51 patients who had undergone robotic staging with aortic lymphadenectomy for different gynaecologic malignancies was performed. Results. The primary diagnosis was as follows: 6 cases of endometrial cancer, 31 epithelial ovarian cancer, 9 nonepithelial ovarian cancer, 4 tubal cancer, and 1 cervical cancer. Median BMI was 23 kg/m2. Except for a single case of aortic lymphadenectomy only, both aortic and pelvic lymphadenectomies were performed at the time of the staging procedure. All the para-aortic lymphadenectomies were carried out to the level of the renal veinl but 6 cases were carried out to the level of the inferior mesenteric artery. Hysterectomy was performed in 24 patiens (47%). There was no conversion to LPT. The median console time was 285 (range 195–402) with a significant difference between patients who underwent hysterectomy and those who did not. The median estimated blood loss was 50 mL (range 20–200). The mean number of removed nodes was . The mean number of pelvic nodes was , whereas the mean number of para-aortic nodes was . Conclusions. Robotic transperitoneal infrarenal aortic lymphadenectomy as part of staging procedure is feasible and can be safely performed. Additional trocars are needed when pelvic surgery is also performed.