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KMID : 1141920210370010058
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Annals of Coloproctology
2021 Volume.37 No. 1 p.58 ~ p.60
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Standardized Step-by-step Technique Using Surgical Landmarks in Robotic Lateral Pelvic Lymph Node Dissection
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Bae Jung-Hoon
Koh Woo-Ree
Kim Hyun-Ho
Lee Yoon-Suk
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Abstract
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We aimed to show that a standardized step-by-step robotic approach using surgical landmarks could make lateral pelvic lymph node dissection (LPND) less complicated. We performed robot-assisted LPND consisting of 4 steps using surgical landmarks. The first step is a dissection of uretero-hypogastric fascia, which envelopes the ureter and the hypogastric nerve. The second step is a dissection of the medial side of the external iliac vein located at the lateral border of the obturator lymph nodes (LNs) group. The third step is a dissection of the vesico-hypogastric fascia, which is at the medial border of the obturator LNs group. The final step is a dissection of the internal iliac artery until the Alcock’s canal. Indocyanine green was injected just before surgery around the dentate line to identify the lateral pelvic LNs. Standardization using a robotic approach for LPND guided by surgical landmarks allows a safer and more effective surgery.
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KEYWORD
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Rectal neoplasms, Lateral pelvic lymph node dissection, Robotic surgical procedures
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