Robotic retroperitoneal lymph-node dissection for testicular cancer: initial experience

To show that Robotic-Assisted Retroperitoneal Lymph-Node Dissection (RA-RPLND) is feasible, safe and has good oncological outcomes for patients. We present one of the first case series from the UK regarding this operative approach. This review was registered and carried out in line with the Trust's audit guidelines. A retrospective analysis was conducted on RA-RPLND procedures performed at our centre, all using the da Vinci Si system. We analysed indications, chemotherapy status, complications, and oncological outcomes. Twenty-four patients, with a mean age of 36 years (range: 18-68), underwent RA-RPLND. The most common indication was residual mass (79%), with 92% of patients being post-chemotherapy. Mean console time and blood loss were 171 min and 190 ml, respectively. One case was converted to open surgery due to bleeding from the left renal vein, and one patient developed a chyle leak, managed conservatively. There were no peri-operative deaths. The mean lymph-node packet size was 72 mm, with a mean node yield of 10. Teratoma was the most common pathology (70%). The mean length of stay was 1.5 days. Our case series demonstrates that RA-RPLND is a feasible and safe option for patients. With the growing availability of robotic surgery, this approach may gain popularity, though it requires careful pre-operative planning and advanced robotic skills.