Feasibility and Outcome of RA-RPLND in Post-Chemotherapy Residual Mass in Testicular Ca.

This video, Produced by Vattikuti Fellow Dr. Manish Garg, was awarded Second Place at the KS National Robotic Surgery Video Awards, December 2018 at the Robotic Surgeons Council of India Meeting. Here is the Abstract:

Feasibility and outcome of Robot-assisted retroperitoneal lymph node dissection in post-chemotherapy residual mass in testicular cancer patients

Introduction:

To evaluate the surgical feasibility and oncological outcome of robot-assisted retroperitoneal lymph node dissection (RA-RPLND) in patients of testicular tumor with post chemotherapy residual retroperitoneal mass.

Methods:

A total of 18 patients underwent RA-RPLND between January 2014 and March 2018 at our institute. Data regarding patient demography, tumour characteristics and surgical, pathological and oncological outcome was collected retrospectively.

Results:

RA-RPLND was successfully completed in all the 18 patients. All patients underwent RPLND using Xi or Si Intuitive surgical Robotic system. Ten patients underwent RPLND in supine position and rest 6 in lateral position. Mean operative time was 180.8 min, mean blood loss was 207.7 ml, and mean length of hospital stay was 4.31 days. The mean yield of lymph node was 20. Ten patients had positive lymph nodes while eight patients had only necrosis in lymph nodes. After median follow-up 18 months (range 4-38 months), no systemic or retroperitoneal recurrence was found. Three patients developed chyle leak. Two patients were managed conservatively with diet modification and one with intranodal lipiodol lymphangiography.

Conclusion:

RA-RPLND is safe and feasible for post chemotherapy residual mass with accepted compilation rate, but larger studies are required to establish its diagnostic and therapeutic utility along with safety of the procedure.

Manish Garg, VF Fellow RGCI&RC

Narrated robotic surgery video, with PPT’s, photo, CT Scans and well labeled robotic surgery clips. 07:57.