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:


To evaluate the anatomical location of sentinel lymph nodes (SLN) following intra-operative cervical injection in endometrial cancer.


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.


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


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.

The video is narrated, with clear robotic surgery footage, including ‘da Vinci Firefly’ imaging showing critical anatomy during surgery. 04:57

Gynecology, Oncology