AB005. SOH23ABS_086. Robot-assisted laparoscopic retro-peritoneal lymphadenectomy during right radical nephrectomy: operative technique with a dual-console Xi da Vinci surgical system
Urology/Gynaecology/Video Session

AB005. SOH23ABS_086. Robot-assisted laparoscopic retro-peritoneal lymphadenectomy during right radical nephrectomy: operative technique with a dual-console Xi da Vinci surgical system

Mohamed Zeid, Olwyn Lynch, Mohammed Ibnouf, Silviu David, Numan Nabi, Thomas Jacob, Mohammed Abdelrahman, Mamoun Abdelrahman, Subhasis Giri

Department of Urology & Robotic Surgery, University Hospital Limerick, Dooradoyle, Limerick, Ireland

Background: Retro-peritoneal lymphadenectomy (RPLND) may benefit in selected cases of locally advanced renal cell cancer during radical nephrectomy (RN). Open RPLND has significant morbidity and this can be minimised with the use of minimally invasive surgery (MIS). Aim is to describe our technique of robotic-assisted laparoscopic RPLND in a complex case of locally advanced multi-focal right renal tumour with hilar, para-caval and retro-caval lymphadenopathy.

Methods: A 72-year-old gentleman with a background history of dyslipidaemia and hypertension presented to us incidental finding of two radiologically suspicious right renal lesions (5.5 and 1.5 cm) and hilar, para-caval and large 2.8 cm retro-caval lymphadenopathy. His case was discussed in our multidisciplinary meeting. He opted for right Radical Nephrectomy with en block extended RPLND of para-caval and retro-caval lymph nodes. We describe operative details and our technique in video.

Results: Following general anaesthesia the patient was positioned into left lateral-decubitus position without table flexion. Intra-operatively we encountered extensive adhesion with inferior vena cava and retro-peritoneum due to desmoplastic reaction. En-block excision of right kidney with tumour, adrenal gland, right para-caval and retro-caval lymph nodes was performed with the use of da Vinci dual console robotic platform. There were no intra-operative or post-operative complications. Operative time was 180 minutes. Blood loss was 75 mL.

Conclusions: Robotic-assisted laparoscopic RPLND is technically challenging but feasible and can be performed safely with the advantages of MIS.

Keywords: Minimally invasive surgery (MIS); para-caval; retro-caval; retro-peritoneal lymphadenectomy (RPLND); robot-assisted laparoscopic

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-23-ab005
Cite this abstract as: Zeid M, Lynch O, Ibnouf M, David S, Nabi N, Jacob T, Abdelrahman M, Abdelrahman M, Giri S. AB005. SOH23ABS_086. Robot-assisted laparoscopic retro-peritoneal lymphadenectomy during right radical nephrectomy: operative technique with a dual-console Xi da Vinci surgical system. Mesentery Peritoneum 2023;7:AB005.

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