Robot-assisted retroperitoneal lymph node dissection (RA-RPLND) in the adolescent population

A. P. Glaser, D. K. Bowen, B. W. Lindgren, J. J. Meeks*

*Corresponding author for this work

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Background Robot-assisted retroperitoneal lymph node dissection (RA-RPLND) has built on success and techniques of laparoscopic RPLND, with the added benefits of robotic technology. This paper demonstrates use of the da Vinci Xi® system for RA-RPLND in two adolescent patients. Methods Case #1: A 17-year-old male presented with a left testicular mass and elevated alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG). Pathology revealed a mixed non-seminomatous germ cell tumor (60% embryonal, 35% yolk sac, 5% choriocarcinoma, + lymphovascular invasion). Tumor marker normalized post-orchiectomy, and staging imaging was without evidence of metastatic disease. After discussion of options he opted to undergo RA-RPLND. Case #2: A 15-year-old male presented with a right para-testicular mass and negative tumor markers. He underwent inguinal exploration and excision of the paratesticular mass. Final pathology revealed an ectomesenchymoma with a spindle cell rhabdomyosarcoma component. Staging imaging was negative, and after discussion of options he underwent completion orchiectomy and RA-RPLND. Results The patient in Case #1 underwent a left modified-template nerve-sparing RA-RPLND. Sixteen lymph nodes were negative for tumor. The patient in Case #2 underwent complete bilateral nerve-sparing RA-RPLND. Forty-two lymph nodes were negative for tumor. Estimated blood loss was <50 cc for both cases, and console time averaged 262 min. Conclusion This was a report of two cases of RA-RPLND in the adolescent population. RA-RPLND is technically feasible in this population, and further study of RA-RPLND is needed to determine long-term outcomes, as this technique is becoming more widely adopted.

Original languageEnglish (US)
Pages (from-to)223-224
Number of pages2
JournalJournal of Pediatric Urology
Volume13
Issue number2
DOIs
StatePublished - Apr 2017

Keywords

  • Lymph node excision
  • Pediatrics
  • Robotics
  • Testicular neoplasms
  • Urological surgical procedures

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Urology

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