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Robotic assisted cytoreductive surgery, removal of a recurrent disease in the right pericaval lymph node in a patient with ovarian cancer with the robotic Xi platform

Obstetrics & Gynecology Science 2021년 64권 6호 p.560 ~ 564
Shoraka Massoud, Metwally Hadeer, Carbajal-Mamani Semiramis L., Cardenas-Goicoechea Joel,
소속 상세정보
 ( Shoraka Massoud ) - University of Florida College of Medicine Department of Obstetrics and Gynecology
 ( Metwally Hadeer ) - University of Florida College of Medicine Department of Obstetrics and Gynecology
 ( Carbajal-Mamani Semiramis L. ) - University of Florida College of Medicine Department of Medicine
 ( Cardenas-Goicoechea Joel ) - University of Florida College of Medicine Department of Obstetrics and Gynecology

Abstract


Objective: The standard approach for recurrent ovarian cancer is laparotomy. In this video, we present a cytoreductive surgery using the robotic Xi platform to remove a 2.7 cm pericaval tumor.

Methods: A narrative video demonstration of robotic-assisted surgery to remove recurrent ovarian cancer in a pericaval lymph node. A 62-year-old female presented with recurrent carcinoma of the pericaval lymph node. After 40 months of surveillance, the patient was asymptomatic, but a computed tomography (CT) scan showed an isolated mass (2.7×2.3 cm) in the right pericaval lymph node. Her cancer antigen (CA)-125 level increased from 26 to 46 U/mL. The robotic Xi platform was used to remove the metastatic lymph nodes. The first step was diagnostic laparoscopy. The second step was robotic port placement below the umbilicus. The third step was dissection and identification of landmarks, and the last step was removal of the tumor and closure.

Results: The metastatic lymph nodes were removed. The patient was discharged on postoperative day 1 and had no postoperative complications. Her CA-125 level dropped to 17 U/mL two weeks after surgery. Pathology showed metastatic high-grade serous carcinoma in one lymph node, consistent with the patient’s known primary. Two additional lymph nodes were removed and negative for carcinoma. Pelvic washings were negative for malignancy.

Conclusion: Robotic-assisted surgery is safe and feasible in selected patients with isolated recurrent disease.

키워드

Ovarian neoplasm; Recurrence; Lymph nodes; Cytoreduction surgical procedures; Robotic surgical procedures

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