A typical Locations of Sentinel Lymph Nodes in Endometrial Cancer
Drs. Reshu Agarwal & Anupama Rajanbabu of the Amrita Institute of Medical Sciences, Kochi, India, produced this KS Robotic Surgery Award-winning video for the Robotic Surgeons Council of India. Here is their abstract:
INTRODUCTION:
To evaluate the anatomical location of sentinel lymph nodes (SLN) following intra-operative cervical injection in endometrial cancer.
METHODS:
All consecutive patients with endometrial cancer undergoing sentinel lymph node mapping were included in this prospective study following intra-operative cervical injection of tracers. Areas of SLN detection distribution were mapped.
RESULTS:
Among 64 patients undergoing successful SLN mapping and SLN dissection, there were 138 SLNs removed, and 7.9% of these SLNs found in 17.2% of patients, were detected in areas not routinely harvested during a standard lymph node dissection. These included the internal iliac vein, parametrial, pre-sacral areas, and direct involvement of high common iliac and para-aortic nodes without the involvement of pelvic nodes. Out of 7 SLN positive cases, SLN in the atypical location was the only node with metastatic disease in 3/7 (42.9%) patients
CONCLUSION:
SLN mapping using intra-operative cervical injection is capable to map out areas not typically included in a standard lymphadenectomy. The sentinel node is the most relevant lymph node to analyze and may enable to discover metastatic disease in unusual areas.
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The video is narrated, with clear robotic surgery footage, including ‘da Vinci Firefly’ imaging showing critical anatomy during surgery. 04:57
Date
August 15, 2020
