#178 Robotic Lateral Lymph Node Dissection Dr. Ankit Sharma, Dr. Avanish Saklani

This is one of the 2023 KS International Innovation Awards videos selected for inclusion in the Vattikuti Foundation – ORSI Humans on the Cutting Edge of Robotic Surgery Conference, October 6, 7 & 8, 2023 in Ghent, Belgium. Posting does not imply that is has been selected as a Finalist, just that the content will be discussed at the Conference.

From the entry: Abstract:

Title: Robotic Lateral Lymph Node Dissection: A Video Vignette Ankit Sharma1, Sanket Banker1, Mufaddal Kazi1, Ashwin Desouza1, Avanish Saklani1 1: Tata Memorial Hospital

Introduction: Lateral lymph node dissection for rectal cancer is routinely performed for persistent lymphadenopathy after neo-adjuvant therapy. It is a technically challenging procedure and has a relatively long learning curve1. The use of robotic platform for this procedure facilitates complete clearance of the lymph nodes. With superior and stable vision system, improved dexterity and need of minimal assistance, the robotic platform helps to eradicate lateral lymph nodes in the narrow confines of the pelvic side wall. In particular, it helps in dissection along the branches of the internal iliac vessels, and clearance of the nodes along the inferior vesicle artery, often known as the ‘Achilles heel’ of lateral lymph node dissection.

Methods: The delineation of the pelvic spaces and landmarks during dissection is of great importance in order to achieve complete clearance and preservation of important neurovascular structures. We depict our stepwise approach of robotic lateral lymph node dissection on the left side in a patient with locally advanced rectal cancer.

Approval of the institute ethical board was not needed as it was a single patient video and the identity of the patient has not been disclosed. Results: Informed consent was taken from the patient for the procedure. Patient had an uneventful post- operative recovery and was discharged on post operative day 7. Histopathology showed pathologically complete response, and the patient is currently on observation.

References: https://linkinghub.elsevier.com/retrieve/pii/S0748798321009501

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