V06-10: Robot-assisted Retroperitoneal Lymph Node Dissection for Advanced Testicular Cancer
Retroperitoneal lymph node dissection (RPLND) remains a cornerstone of management in advanced testicular carcinoma. Robotic approaches have emerged as an alternative to traditional open techniques. Potential advantages of minimally invasive approaches include reduced blood loss, perioperative morbidity and length of stay as well as faster convalescence and improved cosmesis.
We reviewed our series of 5 consecutive patients undergoing robot-assisted RPLND for advanced testicular cancer (Stage IIA or higher). Data was collected on operative time, estimated blood loss, intra- and postoperative complications and pathological outcomes.
Median age was 22 (22-26). Three patients had primary RPLND for Stage IIA disease and two had post-chemotherapy RPLND for residual masses (see Video). Median (range) operating time and estimated blood loss was 360 minutes (270-400) and 50mL (10-100) respectively. None of the patients required intra- or post-operative transfusions. Median node count was 27 (18-40). Median positive node count was 3 (1-5). Median time to bowel recovery and length of stay was 1 day (1-2). There were 2 minor complications (chylous ascites managed with dietary modification and deep vein thrombosis) and no gastrointestinal, genitourinary or wound complications. There were no major complications or readmissions. There were no recurrences at 6 months follow-up.
Robotic-assisted RPLND is safe and feasible for advanced testicular cancer. Our data suggests that the robotic approach minimizes surgical morbidity and reduces length of hospital stay without compromising lymph node yield or early oncological outcomes. Further follow up is required to confirm this technique long-term oncological efficacy.