Feasibility of Laparoscopic Extraperitoneal Pelvic Lymphadenectomy in Obese Endometrial Cancer Patients

ObjectiveTo describe the feasibility of the extraperitoneal approach to perform complete para-aortic and pelvic lymphadenectomy in patients with endometrial cancer. Theoretically, the extraperitoneal approach is technically easier in obese patients as it naturally creates a bowel-free operative field.MethodsThis is a prospective descriptive study evaluating laparoscopic extraperitoneal pelvic lymphadenectomy in patients with endometrial cancer, and 20 endometrial cancer patients were enrolled in the trial.ResultTwo cases were shifted to open and excluded from the trial. The median BMI of the patients was (37.5); in 3 (16.6%) cases, right nodal dissection was performed through the transperitoneal approach. The average number of pelvic nodal yield was (20). The mean total operative time was 298 (& PLUSMN; 53.2) minutes. The mean lymphadenectomy time was 194.4 (& PLUSMN; 34.3) minutes. The mean blood loss was 120 (& PLUSMN; 25.2) ml. The mean hospital stays were 1.67 (& PLUSMN; 0.76) days. No patient experienced tumor recurrence with a mean follow-up of 12 (& PLUSMN; 5.6) months.ConclusionLaparoscopic extraperitoneal pelvic lymphadenectomy is a feasible, effective, and safe approach and has added value when offered to obese females such as cases with endometrial cancer.