Preliminary technique of laparoscopic extraperitoneal infrarenal paraaortic lymphadenectomy in the porcine model

I. Atlas, M. B. Sert, J. M. Childers

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

We developed an extraperitoneal approach to laparoscopic infrarenal paraaortic lymphadenectomy in the porcine model, with the ultimate aim of shortening the long learning curve of this procedure in humans. Surgery was performed on four females pigs with three 10-mm cannulas placed along the midaxillary line in prone position. The first and second pigs underwent subsequent laparotomy to evaluate the adequacy of lymph node dissection and complications. In all four animals, complete infrarenal paraaortic lymphadenectomy was successful, retrieving between 6 and 11 lymph nodes (average 9). Laparotomy in the first two animals confirmed adequate lymphadenectomy. No complications occurred. Operating time was Shortened dramatically with each procedure (180, 120, 50, 40 min). In the porcine model this approach provides excellent exposure to the entire paraaortic lymphatic chain, is safe, and has a remarkably short learning curve. Development of a similar technique in humans may have significant advantages, including short learning curve, feasibility in obese patients and those with peritoneal adhesions, decreased adhesion formation, and reduced bowel complications associated with postoperative adjuvant irradiation. Further studies are indicated.

Original languageEnglish
Pages (from-to)283-287
Number of pages5
JournalJournal of the American Association of Gynecologic Laparoscopists
Volume5
Issue number3
DOIs
StatePublished - Aug 1998
Externally publishedYes

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