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

ObjectiveTo report the feasibility and reproducibility of single port extraperitoneal para-aortic lymphadenectomy in locally advanced cervical cancer.MethodsThe 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.ResultsFourteen consecutive patients with cervical cancer underwent a laparoscopic staging procedure (3 stage IB2, 10 IIB 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.ConclusionsThis series reports that para-aortic lymphadenectomy technique via the extraperitoneal approach with a multichannel single port is feasible and reproducible.

► This is the first report of para-aortic lymphadenectomy technique via the extraperitoneal approach using a multichannel single port.
► This preliminary series (including 14 consecutive cases) demonstrates the feasibility of this procedure using a multichannel single port approach.