Robot-assisted Retroperitoneal Lymphadenectomy for Non seminomatous Germ Cell Tumor residual disease after chemotherapy
Abstract
INTRODUCTION:In this video we describe a robotic retroperitoneal limphadenectomy for NSGCT residual disease after chemotherapy
METHODS: We present a case of a Robot-assisted Retroperitoneal Lymphadenectomy for Non seminomatous Germ Cell Tumor residual disease after 4 cycles of chemotherapy in a 18-yr old male, who underwent right orchiectomy for non seminomatous germ cell tumor.
The patient was placed in a supine position and a right template limphnode dissection was planned. The anterior aspect of inferior vena cava and aorta is visualised, and the nodal mass is clearly identified. Interaortocaval limphnode dissection is progressively performed, dissecting the limphatic tissue proximal to the nodal mass and isolating its cranial aspect. The residual mass was approached, starting from the aortic aspect, with a shurp and blunt meticolous dissection. The distal aspect of the mass was identified and isolated, with a progressive dissection through the anterior wall of inferior vena cava.
The right template limphnode dissection was completed.
Right spermatic cord was dissected and removed without any robot redocking.
RESULTS: Perioperative course was uneventful. The patient was discharged in postoperative day 5. The pathologic report confirmed the metastatic non seminomatous nature of the mass.
CONCLUSIONS: Robotic retroperitoneal limphadenectomy for NSGCT residual disease is a safe and feasible treatment option in tertiary referral centers