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Standardized Step-by-step Technique Using Surgical Landmarks in Robotic Lateral Pelvic Lymph Node Dissection

Annals of Coloproctology 2021년 37권 1호 p.58 ~ 60
배정훈, Koh Woo-Ree, 김현호, 이윤석,
소속 상세정보
배정훈 ( Bae Jung-Hoon ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Surgery
 ( Koh Woo-Ree ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Surgery
김현호 ( Kim Hyun-Ho ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Surgery
이윤석 ( Lee Yoon-Suk ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Surgery

Abstract


We aimed to show that a standardized step-by-step robotic approach using surgical landmarks could make lateral pelvic lymph node dissection (LPND) less complicated. We performed robot-assisted LPND consisting of 4 steps using surgical landmarks. The first step is a dissection of uretero-hypogastric fascia, which envelopes the ureter and the hypogastric nerve. The second step is a dissection of the medial side of the external iliac vein located at the lateral border of the obturator lymph nodes (LNs) group. The third step is a dissection of the vesico-hypogastric fascia, which is at the medial border of the obturator LNs group. The final step is a dissection of the internal iliac artery until the Alcock’s canal. Indocyanine green was injected just before surgery around the dentate line to identify the lateral pelvic LNs. Standardization using a robotic approach for LPND guided by surgical landmarks allows a safer and more effective surgery.

키워드

Rectal neoplasms; Lateral pelvic lymph node dissection; Robotic surgical procedures

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