Initial Report of Sentinel Lymph Node Identification During Laparoscopic Radical Hysterectomy Using a New Gamma Probe Technology.

Abstract

The standard surgical procedure for early-stage cervical cancer is abdominal radical hysterectomy, including pelvic lymphadenectomy. Currently, minimally invasive surgical techniques for early cervical cancer are progressing; total laparoscopic radical hysterectomy (TLRH) is a possible alternative to abdominal surgery. In addition, sentinel node navigation surgery (SNNS), which can prevent lower limb edema, has been widely used for radical hysterectomy. A radioisotope is injected into the uterine cervix 1 day preoperatively and surgeons carefully identify the correct sentinel lymph nodes (SLNs) to prevent picking up the cervical gamma rays during surgery. It is difficult to identify SLNs in laparoscopic surgery compared to abdominal surgery using the traditional gamma probe, which has the sensor on the tip, since this probe picks up the gamma rays from the uterine cervix. We described 11 cases in which TLRH was combined with SNNS using a new device that accurately detects correct SLNs. The SLNs were detected using a gamma probe that has a sensor built onto the side, without picking up the cervical gamma rays. We believe that the Neoprobe plays a crucial role in SNNS for accurately detecting SLNs and helping determine whether the patient needs to undergo SNNS.