Sentinel Node Mapping – Endometrial cancer- Robotic Platform

The need for Lymphadenectomy in endometrial cancer is a topic of ongoing debate. Two randomized controlled trials did not show any survival advantage for lymphadenectomy but lymph node involvement still remains as one of the most important prognostic factors in endometrial cancer and it guides adjuvant treatment. But Lymphadenectomy is associated with increased surgical and post operative morbidity. Approximately only about 10-15% of patients with apparently early stage endometrial cancer will be lymph node positive. Pre operative and intraoperative risk stratification algorithms to detect patients in whom lymphadenectomy can be avoided has not shown good predictive value. Sentinel lymph node mapping appears promising in this scenario. Biopsy of the mapped sentinel node can give us the necessary prognostic information while avoiding the complications associated with lymphadenectomy. SLN mapping with ICG dye and fluorescent imaging has shown to provide more than 90% detection rates and a negative predictive value of 95% and can be used as an alternative to lymphadenectomy where facilities are available.