Minimally invasive lymphocele drainage using the Da Vinci® single port platform: step-by- step technique

Reddy, Sunil; Moschovas, Marcio Covas; Bhat, Seetharam; Noel, Jonathan; Helman, Talia; Perera, Roshane; Rogers, Travis; Patel, Vipul

doi:10.1590/S1677-5538.IBJU.2021.0272

ABSTRACT

Background:

Reports in the literature describe lymphocele formation in up to half of patients following pelvic lymph node dissection (PLND) (¹1 Briganti A, Chun FK, Salonia A, Suardi N, Gallina A, Da Pozzo LF, et al. Complications and other surgical outcomes associated with extended pelvic lymphadenectomy in men with localized prostate cancer. Eur Urol. 2006;50:1006-13.) in robotic-assisted radical prostatectomy (RARP), with 1-2% requiring intervention (²2 Kang SG, Shim JS, Onol F, Bhat KRS, Patel VR. Lessons learned from 12,000 robotic radical prostatectomies: Is the journey as important as the outcome? Investig Clin Urol. 2020;61:1-10.). The advantage of surgical approach is permanent excision of the lymphocele capsule and fewer days with pelvic drains compared to percutaneous drainage. This study aims to describe the step-by-step surgical management of symptomatic lymphoceles using a less invasive robotic platform, the Da Vinci® Single Port (SP).

Material and Methods:

We describe the technique of lymphocelectomy and marsupialization with the Da Vinci® SP for symptomatic lymphocele. For this study, several treatment modalities for symptomatic lymphoceles were available, including percutaneous drainage, sclerosing agents, and surgical marsupialization. All the data for this study were obtained through the procedure via Da Vinci® SP.

Results:

Operative time for the case was 84 minutes. Blood loss was 25ml. No intra- or post- operative complications were reported. The patient had his drain removed in under 24 hours after surgery. The mean follow-up period was 7.7 months. There were no complications or lymphocele recurrence.

Conclusion:

Da Vinci® SP lymphocelectomy is safe and feasible with satisfactory outcomes. The SP enables definitive treatment of the lymphocele sac (³3 Covas Moschovas M, Helman T, Reddy S, Bhat S, Rogers TP, Sandri M, et al. Minimally Invasive Lymphocele Drainage using the da Vinci® Single Port Platform: Step-by-Step Technique of a prostate cancer referral center. J Endourol. 2021. Epub ahead of print.), reducing the number of days with abdominal drains and allows further decrease in surgical invasiveness with fewer incisions and better cosmesis.

REFERENCES

¹
Briganti A, Chun FK, Salonia A, Suardi N, Gallina A, Da Pozzo LF, et al. Complications and other surgical outcomes associated with extended pelvic lymphadenectomy in men with localized prostate cancer. Eur Urol. 2006;50:1006-13.
²
Kang SG, Shim JS, Onol F, Bhat KRS, Patel VR. Lessons learned from 12,000 robotic radical prostatectomies: Is the journey as important as the outcome? Investig Clin Urol. 2020;61:1-10.
³
Covas Moschovas M, Helman T, Reddy S, Bhat S, Rogers TP, Sandri M, et al. Minimally Invasive Lymphocele Drainage using the da Vinci® Single Port Platform: Step-by-Step Technique of a prostate cancer referral center. J Endourol. 2021. Epub ahead of print.

Publication Dates

Publication in this collection
11 Mar 2022
Date of issue
Mar-Apr 2022

History

Received
08 June 2021
Accepted
16 June 2021
Published
30 Aug 2021

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

[1] ¹
Briganti A, Chun FK, Salonia A, Suardi N, Gallina A, Da Pozzo LF, et al. Complications and other surgical outcomes associated with extended pelvic lymphadenectomy in men with localized prostate cancer. Eur Urol. 2006;50:1006-13.

[2] ²
Kang SG, Shim JS, Onol F, Bhat KRS, Patel VR. Lessons learned from 12,000 robotic radical prostatectomies: Is the journey as important as the outcome? Investig Clin Urol. 2020;61:1-10.

[3] ³
Covas Moschovas M, Helman T, Reddy S, Bhat S, Rogers TP, Sandri M, et al. Minimally Invasive Lymphocele Drainage using the da Vinci® Single Port Platform: Step-by-Step Technique of a prostate cancer referral center. J Endourol. 2021. Epub ahead of print.

Brasil