Single-port laparoscopy and extraperitoneal para-aortic lymphadenectomy: About fourteen consecutive cases

Objective. To report the feasibility and reproducibility of single port extraperitoneal para-aortic lymphadenectomy in locally advanced cervical cancer. Methods. The same single port was used for the transperitoneal step and the extraperitoneal approach used thereafter (in the absence of peritoneal disease) for the lymphadenectomy.. Para-aortic lymphadenectomy was performed via a left-sided extraperitoneal approach. Results. Fourteen consecutive patients with cervical cancer underwent a laparoscopic staging procedure (3 stage 182, 10118 and 1 stage IVA). No patient had para-aortic FDG uptake on PET/CT. In one case lymphadenectomy was unfeasible because of vascular anomalies of the renal vessels (low insertion of 2 left renal arteries). The median operative time was 190 min (range, 135-250). The median number of lymph nodes removed was 14 [range, 2-23]. The definitive pathological analysis revealed that three patients had metastatic disease. No conversion to conventional multiport laparoscopy was necessary. Conclusions. This series reports that para-aortic lymphadenectomy technique via the extraperitoneal approach with a multichannel single port is feasible and reproducible. (C) 2011 Elsevier Inc. All rights reserved.