The Journal of Minimally Invasive Gynecology
Volume 17, Issue 2 , Pages 180-185, March 2010

Robotic Pelvic and Aortic Lymphadenectomy for Endometrial Cancer: The Console Surgeon's Perspectives on Surgical Technique and Directing the Assistant

  • Leigh G. Seamon, DO, MPH

      Affiliations

    • Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio
    • ,
  • David E. Cohn, MD

      Affiliations

    • Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio
    • ,
  • Debra L. Richardson, MD

      Affiliations

    • Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio
    • ,
  • Jason D. Hurt, MD

      Affiliations

    • Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio
    • ,
  • Edward C. Nickerson

      Affiliations

    • Center for Robotic and Computer Assisted Surgery, The Ohio State University College of Medicine, Columbus, Ohio
    • ,
  • Jeffrey M. Fowler, MD

      Affiliations

    • Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio
    • Corresponding Author InformationCorresponding author: Jeffrey M. Fowler, MD, The Ohio State University College of Medicine, M-210 Starling-Loving, 320 West Tenth Ave, Columbus, Ohio 43210-1228.

Received 27 July 2009; accepted 4 November 2009.

Abstract 

Objective

Our purpose is to describe and demonstrate basic console dissection techniques in robotic hysterectomy, aortic and pelvic lymphadenectomy for endometrial carcinoma, and efficient methods to direct the assistant.

Methods

The operating room and patient are prepared as previously detailed. Adequate exposure is the key to a successful procedure, and a skilled bedside assistant is essential in developing the dissection. Clear communication between the console surgeon and assistant plays a critical role. In addition, proper use of the robotic fourth arm allows additional retraction and permits smooth case progression.

Results

We have completed more than 120 robotic hysterectomies, pelvic-aortic lymphadenectomies for endometrial cancer with these key steps.

Conclusions

A systematic routine and effective use of the bedside assistant is essential for successfully completing robotic hysterectomy and aortic and pelvic lymphadenectomy. This manuscript and video illustrates our method emphasizing an efficient and comprehensive technique for this procedure.

Key words: Endometrial cancer, Gynecology, Hysterectomy, Lymphadenectomy, Robotic surgery

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 The authors declare that there are no conflicts of interest.

PII: S1553-4650(09)01247-3

doi:10.1016/j.jmig.2009.11.006

The Journal of Minimally Invasive Gynecology
Volume 17, Issue 2 , Pages 180-185, March 2010

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