Hand-assisted laparoscopic retroperitoneal lymph node dissection for nonseminomatous testicular cancer

E. Holman, Gábor Kovács, Tibor Flaskó, Csaba Maróti, János Vancsora, Csaba Tóth, M. Salah

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Purpose: We describe our initial experience with hand-assisted laparoscopic retroperitoneal lymph node dissection for nonseminomatous testicular cancer. Materials and Methods: Between April 2002 and December 2004, 10 patients with testicular tumor were operated on, 6 on the right side and 4 on the left side. Eight patients were in clinical stage I, one patient was in clinical stage IIA, and one patient was in clinical stage IIB disease. Depending on the tumor site, a 6-7 cm mid-lower or -upper laparotomy was done, the HandPort (Smith & Nephew, Andover, MA) was placed in the abdominal wall, and the left hand of the surgeon was inserted into the abdomen. Four laparoscopic ports were also inserted. The ascending or descending colon was mobilized completely. The retroperitoneal lymph nodes were dissected and removed according to the modification of Weissbach and colleagues. Results: The average operative time was 258 min (range, 150-432 min). One patient required reoperation because of postoperative bleeding. The average postoperative hospital stay was 3.5 (range, 3-10) days. Patients with stage IIA or IIB disease on histopathology received 2-3 courses of combined chemotherapy. Antegrade ejaculation was preserved in all patients. During follow-up that ranged from 9 to 36 months, there was no local recurrence or distant metastasis. Conclusion: Hand assitance makes the laparoscopic operation simpler, faster, and safer. A 6-7 cm muscle-splitting incision should be advantageous for patients compared to the xyphopubic laparotomy of the open procedure. To our knowledge this is the first report on hand-assisted laparoscopic retroperitoneal lymph node dissection.

Original languageEnglish
Pages (from-to)16-20
Number of pages5
JournalJournal of Laparoendoscopic and Advanced Surgical Techniques - Part A
Volume17
Issue number1
DOIs
Publication statusPublished - Feb 2007

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Testicular Neoplasms
Lymph Node Excision
Hand
Laparotomy
Descending Colon
Ascending Colon
Ejaculation
Abdominal Wall
Operative Time
Reoperation
Abdomen
Length of Stay
Lymph Nodes
Hemorrhage
Neoplasm Metastasis
Recurrence
Drug Therapy
Muscles

ASJC Scopus subject areas

  • Surgery

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Hand-assisted laparoscopic retroperitoneal lymph node dissection for nonseminomatous testicular cancer. / Holman, E.; Kovács, Gábor; Flaskó, Tibor; Maróti, Csaba; Vancsora, János; Tóth, Csaba; Salah, M.

In: Journal of Laparoendoscopic and Advanced Surgical Techniques - Part A, Vol. 17, No. 1, 02.2007, p. 16-20.

Research output: Contribution to journalArticle

Holman, E. ; Kovács, Gábor ; Flaskó, Tibor ; Maróti, Csaba ; Vancsora, János ; Tóth, Csaba ; Salah, M. / Hand-assisted laparoscopic retroperitoneal lymph node dissection for nonseminomatous testicular cancer. In: Journal of Laparoendoscopic and Advanced Surgical Techniques - Part A. 2007 ; Vol. 17, No. 1. pp. 16-20.
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