Rectal mobilization for laparoscopic pelvic lymphadenectomy of the lower paracervical pathway in patients with uterine cancer

Objective The pelvic lymphatic drainage system comprises the upper and lower paracervical pathways (LPPs). Lymph node dissection of the LPP, including the cardinal ligament, internal iliac, internal common iliac, and presacral lymph nodes, requires higher surgical skills because of the anatomical li...

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Autores principales:	Iori Kisu, Hidetaka Nomura, Miho Iida, Kouji Banno, Tetsuro Shiraishi, Moito Iijima, Kayoko Nakamura, Kiyoko Matsuda, Nobumaru Hirao
Formato:	article
Lenguaje:	EN KO
Publicado:	Korean Society of Obstetrics and Gynecology 2021
Materias:	cervical cancer laparoscopic surgery pelvic lymphatic pathway uterine cancer Gynecology and obstetrics RG1-991
Acceso en línea:	https://doaj.org/article/de86bc2d86294f859eeef9eafe2cc636
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spelling	oai:doaj.org-article:de86bc2d86294f859eeef9eafe2cc6362021-11-15T00:50:16ZRectal mobilization for laparoscopic pelvic lymphadenectomy of the lower paracervical pathway in patients with uterine cancer2287-85722287-858010.5468/ogs.21190https://doaj.org/article/de86bc2d86294f859eeef9eafe2cc6362021-11-01T00:00:00Zhttp://www.ogscience.org/upload/pdf/ogs-21190.pdfhttps://doaj.org/toc/2287-8572https://doaj.org/toc/2287-8580Objective The pelvic lymphatic drainage system comprises the upper and lower paracervical pathways (LPPs). Lymph node dissection of the LPP, including the cardinal ligament, internal iliac, internal common iliac, and presacral lymph nodes, requires higher surgical skills because of the anatomical limitations of the pelvic cavity and the dissection of vessels while preserving the nerves in the pelvic floor. In this video, we demonstrate rectal mobilization for laparoscopic complete pelvic lymph node dissection of the LPP in patients with uterine cancer. Methods Rectal mobilization was performed before complete pelvic lymph node dissection of the LPP. The pararectal space was opened widely and the connective tissue between the presacral fascia and prehypogastric nerve fascia was dissected bilaterally, allowing the rectum to be pulled. Results This procedure created a wide-open space in the pelvic floor, allowing clear visualization of the nerves and lymph nodes of the LPP. Laparoscopic complete lymph node dissection of the LPP was performed in the open space while preserving the hypogastric and pelvic splanchnic nerves and isolating the extensive network of blood vessels in the pelvic cavity. Conclusion Rectal mobilization enabled the safe execution of laparoscopic complete pelvic lymph node dissection of the LPP in patients with uterine cancer.Iori KisuHidetaka NomuraMiho IidaKouji BannoTetsuro ShiraishiMoito IijimaKayoko NakamuraKiyoko MatsudaNobumaru HiraoKorean Society of Obstetrics and Gynecologyarticlecervical cancerlaparoscopic surgerypelvic lymphatic pathwayuterine cancerGynecology and obstetricsRG1-991ENKOObstetrics & Gynecology Science, Vol 64, Iss 6, Pp 555-559 (2021)
institution	DOAJ
collection	DOAJ
language	EN KO
topic	cervical cancer laparoscopic surgery pelvic lymphatic pathway uterine cancer Gynecology and obstetrics RG1-991
spellingShingle	cervical cancer laparoscopic surgery pelvic lymphatic pathway uterine cancer Gynecology and obstetrics RG1-991 Iori Kisu Hidetaka Nomura Miho Iida Kouji Banno Tetsuro Shiraishi Moito Iijima Kayoko Nakamura Kiyoko Matsuda Nobumaru Hirao Rectal mobilization for laparoscopic pelvic lymphadenectomy of the lower paracervical pathway in patients with uterine cancer
description	Objective The pelvic lymphatic drainage system comprises the upper and lower paracervical pathways (LPPs). Lymph node dissection of the LPP, including the cardinal ligament, internal iliac, internal common iliac, and presacral lymph nodes, requires higher surgical skills because of the anatomical limitations of the pelvic cavity and the dissection of vessels while preserving the nerves in the pelvic floor. In this video, we demonstrate rectal mobilization for laparoscopic complete pelvic lymph node dissection of the LPP in patients with uterine cancer. Methods Rectal mobilization was performed before complete pelvic lymph node dissection of the LPP. The pararectal space was opened widely and the connective tissue between the presacral fascia and prehypogastric nerve fascia was dissected bilaterally, allowing the rectum to be pulled. Results This procedure created a wide-open space in the pelvic floor, allowing clear visualization of the nerves and lymph nodes of the LPP. Laparoscopic complete lymph node dissection of the LPP was performed in the open space while preserving the hypogastric and pelvic splanchnic nerves and isolating the extensive network of blood vessels in the pelvic cavity. Conclusion Rectal mobilization enabled the safe execution of laparoscopic complete pelvic lymph node dissection of the LPP in patients with uterine cancer.
format	article
author	Iori Kisu Hidetaka Nomura Miho Iida Kouji Banno Tetsuro Shiraishi Moito Iijima Kayoko Nakamura Kiyoko Matsuda Nobumaru Hirao
author_facet	Iori Kisu Hidetaka Nomura Miho Iida Kouji Banno Tetsuro Shiraishi Moito Iijima Kayoko Nakamura Kiyoko Matsuda Nobumaru Hirao
author_sort	Iori Kisu
title	Rectal mobilization for laparoscopic pelvic lymphadenectomy of the lower paracervical pathway in patients with uterine cancer
title_short	Rectal mobilization for laparoscopic pelvic lymphadenectomy of the lower paracervical pathway in patients with uterine cancer
title_full	Rectal mobilization for laparoscopic pelvic lymphadenectomy of the lower paracervical pathway in patients with uterine cancer
title_fullStr	Rectal mobilization for laparoscopic pelvic lymphadenectomy of the lower paracervical pathway in patients with uterine cancer
title_full_unstemmed	Rectal mobilization for laparoscopic pelvic lymphadenectomy of the lower paracervical pathway in patients with uterine cancer
title_sort	rectal mobilization for laparoscopic pelvic lymphadenectomy of the lower paracervical pathway in patients with uterine cancer
publisher	Korean Society of Obstetrics and Gynecology
publishDate	2021
url	https://doaj.org/article/de86bc2d86294f859eeef9eafe2cc636
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Rectal mobilization for laparoscopic pelvic lymphadenectomy of the lower paracervical pathway in patients with uterine cancer

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