Laparoscopic extended lymphadenectomy for bladder and prostate cancer

VIDEO

Laparoscopic extended lymphadenectomy for bladder and prostate cancer

Anibal W. Branco; William Kondo; Marcio L. Miranda; Sidney Abreu; Affonso H. A. Camargo; Marcelo L. Miranda; Luciano C. Stunitz

Cruz Vermelha Hospital, Curitiba, Parana, Brazil

^{Correspondence}

ABSTRACT

Purpose: Extended lymphadenectomy in bladder and prostate cancer represents an important step of the surgical treatment of these tumors. Some urological referral centers have been using the laparoscopic approach for these cases. The aim of this video is to demonstrate the surgical technique of laparoscopic extended lymphadenectomy for bladder and prostate cancer.

Case 1: Patient with transitional cell carcinoma of the bladder invading the muscular layer underwent laparoscopic extended lymphadenectomy up to the aortic bifurcation. Total operative time was 100 minutes and intraoperative bleeding was 100cc. Thirteen nodes were retrieved with no neoplasic involvement.

Case 2: Patient with prostate cancer clinical stage T2 was submitted to laparoscopic extended lymphadenectomy with dissection of the internal iliac artery and its branches. Operative time was 55 minutes and intraoperative bleeding was 100cc. Eleven nodes were retrieved with no neoplasic involvement.

Conclusion: Extended lympadenectomy in bladder and prostate cancer is a challenging procedure that can be performed by using the laparoscopic approach following the oncologic concepts.

Int Braz J Urol. 2010; 36 (Video #8): 648_9

Available at: www.brazjurol.com.br/videos/september_october_2010/Branco_648_649video.htm

EDITORIAL COMMENT

This video is yet another demonstration of the excellent lymph node dissection that is possible through a laparoscopic approach. It is interesting that we are returning to this technique which was one of the earliest applications for laparoscopy in urology when used to stage prostate cancer. As we enter an era when an increasing amount of urologic malignancies will be performed using a laparoscopic or robotic approach, videos such as this which demonstrate the anatomy and skill set required are mandatory. The author’s should be congratulated for the efforts at doing a thorough, oncologically sound procedure without any compromise. When performed in this manner, the lymph node dissection may be performed as well, if not better, than by using an open approach. Although at this time, the laparoscopic and robotic assisted laparoscopic approaches may take longer, they may be performed safely with comparable node counts and resection margins as compared to open (Richard et al). We should all be watching closely to the continued development of this evolving technique.

Dr. Karim Kader

Assistant Professor of Urologic Oncology

Wake Forrest University

Winston-Salem, North Carolina, USA

Publication Dates

• Publication in this collection
  06 Dec 2010
• Date of issue
  Oct 2010