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Robot-Assisted Retroperitoneal Lymphadenectomy

  • Haidar M. Abdul-Muhsin
  • James O. L’esperance
  • Michael E. Woods
  • Erik P. Castle
Chapter

Abstract

Robot-assisted retroperitoneal lymph node dissection is a procedure that is now more commonly offered to patients with testicular cancer. Nevertheless, this procedure is technically challenging and is not routinely performed. This chapter will describe the prevention and management of all possible complications that may arise from robot-assisted retroperitoneal lymph node dissection in a stepwise fashion. Since the most effective way to deal with any complication is to avoid it, this chapter will dedicate a significant portion of its content to describe the proper surgical technique that will help achieve this aim. Additionally, the current status of perioperative outcomes and complications will be reviewed.

Keywords

Lymphadenectomy Retroperitoneal lymph node dissection Robotic surgery Complications Testicular cancer 

Abbreviations

IMA

Inferior mesenteric artery

IVC

Inferior Vena Cava

LN

Lymph Nodes

RARPLND

Robot-assisted retroperitoneal lymph node dissection

References

  1. 1.
    Cheney SM, Andrews PE, Leibovich BC, Castle EP. Robot-assisted retroperitoneal lymph node dissection: technique and initial case series of 18 patients. BJU Int. 2015;115(1):114–20.CrossRefPubMedGoogle Scholar
  2. 2.
    Harris KT, Gorin MA, Ball MW, Pierorazio PM, Allaf ME. A comparative analysis of robotic vs laparoscopic retroperitoneal lymph node dissection for testicular cancer. BJU Int. 2015;116(6):920–3.CrossRefPubMedGoogle Scholar
  3. 3.
    Stepanian S, Patel M, Porter J. Robot-assisted laparoscopic retroperitoneal lymph node dissection for testicular cancer: evolution of the technique. Eur Urol. 2016;5(16):00385–7.Google Scholar
  4. 4.
    Pearce SM, Golan S, Gorin MA, Luckenbaugh AN, Williams SB, Ward JF, et al. Safety and early oncologic effectiveness of primary robotic retroperitoneal lymph node dissection for nonseminomatous germ cell testicular cancer. Eur Urol. 2016;24(16):30181–6.Google Scholar
  5. 5.
    Lauritsen J, Kier MG, Bandak M, Mortensen MS, Thomsen FB, Mortensen J, et al. Pulmonary function in patients with germ cell cancer treated with bleomycin, etoposide, and cisplatin. J Clin Oncol. 2016;34(13):1492–9.CrossRefPubMedGoogle Scholar
  6. 6.
    Necchi A, Miceli R, Oualla K, Sonpavde G, Giannatempo P, Raggi D, et al. Effect of bleomycin administration on the development of pulmonary toxicity in patients with metastatic germ cell tumors receiving first-line chemotherapy: a meta-analysis of randomized studies. Clin Genitourin Cancer. 2016;8(16):30255.Google Scholar
  7. 7.
    Roncolato FT, Chatfield M, Houghton B, Toner G, Stockler M, Thomson D, et al. The effect of pulmonary function testing on bleomycin dosing in germ cell tumours. Intern Med J. 2016;46(8):893–8.CrossRefPubMedGoogle Scholar
  8. 8.
    Jackson RM. Pulmonary oxygen toxicity. Chest. 1985;88(6):900–5.CrossRefPubMedGoogle Scholar
  9. 9.
    Subramanian VS, Nguyen CT, Stephenson AJ, Klein EA. Complications of open primary and post-chemotherapy retroperitoneal lymph node dissection for testicular cancer. Urol Oncol. 2010;28(5):504–9.CrossRefPubMedGoogle Scholar
  10. 10.
    Forrest JB, Clemens JQ, Finamore P, Leveillee R, Lippert M, Pisters L, et al. AUA best practice statement for the prevention of deep vein thrombosis in patients undergoing urologic surgery. J Urol. 2009;181(3):1170–7.CrossRefPubMedGoogle Scholar
  11. 11.
    Wolf JS Jr, Bennett CJ, Dmochowski RR, Hollenbeck BK, Pearle MS, Schaeffer AJ. Best practice policy statement on urologic surgery antimicrobial prophylaxis. J Urol. 2008;179(4):1379–90.CrossRefPubMedGoogle Scholar
  12. 12.
    Akhavan A, Gainsburg DM, Stock JA. Complications associated with patient positioning in urologic surgery. Urology. 2010;76(6):1309–16.CrossRefPubMedGoogle Scholar
  13. 13.
    Pariser JJ, Pearce SM, Patel SG, Anderson BB, Packiam VT, Shalhav AL, et al. Rhabdomyolysis after major urologic surgery: epidemiology, risk factors, and outcomes. Urology. 2015;85(6):1328–32.CrossRefPubMedGoogle Scholar
  14. 14.
    Pemberton RJ, Tolley DA, van Velthoven RF. Prevention and management of complications in urological laparoscopic port site placement. Eur Urol. 2006;50(5):958–68.CrossRefPubMedGoogle Scholar
  15. 15.
    Abdul-Muhsin HM, L’Esperance JO, Fischer K, Woods ME, Porter JR, Castle EP. Robot-assisted retroperitoneal lymph node dissection in testicular cancer. J Surg Oncol. 2015;112(7):736–40.CrossRefPubMedGoogle Scholar
  16. 16.
    Thiel R, Adams JB, Schulam PG, Moore RG, Kavoussi LR. Venous dissection injuries during laparoscopic urological surgery. J Urol. 1996;155(6):1874–6.CrossRefPubMedGoogle Scholar
  17. 17.
    Bahnson RR, Andriole GL, Clayman RV, Catalona WJ. Catecholamine excess: probable cause of postoperative tachycardia following retroperitoneal lymph node dissection (RPLND) for testicular carcinoma. J Surg Oncol. 1989;42(2):132–5.CrossRefPubMedGoogle Scholar
  18. 18.
    Kenney PA, Tuerk IA. Complications of laparoscopic retroperitoneal lymph node dissection in testicular cancer. World J Urol. 2008;26(6):561–9.CrossRefPubMedGoogle Scholar
  19. 19.
    Williams SB, McDermott DW, Winston D, Bahnson E, Berry AM, Steele GS, et al. Morbidity of open retroperitoneal lymph node dissection for testicular cancer: contemporary perioperative data. BJU Int. 2010;105(7):918–21.CrossRefPubMedGoogle Scholar
  20. 20.
    Evans JG, Spiess PE, Kamat AM, Wood CG, Hernandez M, Pettaway CA, et al. Chylous ascites after post-chemotherapy retroperitoneal lymph node dissection: review of the M. D. Anderson experience. J Urol. 2006;176(4 Pt 1):1463–7.CrossRefPubMedGoogle Scholar
  21. 21.
    Baniel J, Foster RS, Rowland RG, Bihrle R, Donohue JP. Management of chylous ascites after retroperitoneal lymph node dissection for testicular cancer. J Urol. 1993;150(5 Pt 1):1422–4.CrossRefPubMedGoogle Scholar
  22. 22.
    Al-Busafi SA, Ghali P, Deschenes M, Wong P. Chylous ascites: evaluation and management. ISRN Hepatol. 2014;3:240473.Google Scholar
  23. 23.
    Abdul-Muhsin H, Marshall M, Stroup S, L’Esperance J, Woods M, Porter J, et al. MP81-16 perioperative and early oncological outcomes following robot assisted retroperitoneal lymph node dissection for testicular cancer: a multi-institutional study. J Urol. 195(4):e1059.Google Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Haidar M. Abdul-Muhsin
    • 1
  • James O. L’esperance
    • 2
  • Michael E. Woods
    • 3
  • Erik P. Castle
    • 1
  1. 1.Department of UrologyMayo ClinicPhoenixUSA
  2. 2.Department of UrologyNaval Medical Center San DiegoSan DiegoUSA
  3. 3.Department of UrologyUNC Chapel HillChapel HillUSA

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