THE LAPAROSCOPIC OBTURATOR LYMPH NODE DISSECTION
IN PATIENTS WITH PROSTATIC CARCINOMA
Article published in Urologia Polska 1999/52/2.
authors
-
Grzegorz Kata, Artur A. Antoniewicz, Andrzej Borówka
- Oddział Urologii Centralnego Szpitala Kolejowego w Warszawie
Ordynator Oddziału: prof. dr hab. n. med. A. Borówka
keywords
-
prostate carcinoma lymphadenectomy laparoscopy
summary
- 20 patients aged 51-75 underwent laparoscopic obturator lymph node
- dissection between 1996-1998. All of them with histologically proved prostate
- carcinoma (clinical stage T ? 3 No M()) were ±ualified for staging before
- radiotherapy. The method of the bilateral access to fossa obturatoria called
- "butterfly suture" was performed in 15 patients. The idea of the techni±ue is to
- make a suture looking like butterfly at laparoscopy. A PDS suture on rectilinear
- needle is introduced into the perineal cavity percutaneously. Afterwards both
- of the medial edges of incised peritoneumare protracted. The suture after
- crossing is knotted extracorporeally - fraction of the ends of the suture gives
- wide opening of both obturator fossas. Lymphatic tissue was removed
- completely. The nodes were metastatic in three patients. There were no
- intraoperative complications. We observed early postoperative complications
- in three patients. The lymphocele occurred in one patient two weeks following
- radiotherapy.
- Considering our experience laparoscopy is minimally invasive and safe
- method of removal of obturator lymph nodes at patient with prostatic carcinoma
- for the staging before radiotherapy or perineal prostatectomy. Laparoscopic
- lymphadenectomy is suitable alternative to other more invasive techni±ues.
- The "butterfly suture" improves performing procedure.
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