Infrarenal Para-Aortic Lymphadenectomy via Laparoendoscopic Single-Site Approach

Abstract

Video Objective To perform the procedure of Laparoendoscopic Single-Site surgery (LESS) for infrarenal para-aortic nodal dissection and demonstrate the feasibility and safety of infrarenal para-aortic lymphadenectomy via LESS Setting A 59-year old female who has no special past history presented an university and tertiary care hospital with abnormal uterus bleeding after menopause. The bimanual examination was no special. The laboratory test was normal, exceptionally, the CA-125 level of 181.6 U/ml (normal Interventions The comprehensive staging surgery was performed by an experienced gynecologist via LESS approach. The comprehensive staging surgery was successfully completed, and the video mainly show the para-aortic lymph nodes dissection up to level of left renal vein. The operation time of the para-aortic lymphadenectomy was 100 min. There were no intra- and post-operative complications. The histopathology was well-differentiated endometrial adenocarcinoma with deep myometrium invasion but the bilateral adnexa, the 17 pelvic nodes and the 18 para-aortic nodes were negative. The FIGO stage was IB Conclusion The para-aortic lymphadenectomy up to the level of infrarenal vein is feasible via LESS. The LESS approach can provide easier access to the upper abdominal regions comparing with traditional laparoscopy and facilitate the high level para-aortic lymphadenectomy, with the advantage of faster recovery, shorter hospital day, lesser postoperative pain and incisional mobility and better cosmetic result.