Minilaparoscopic aortic lymphadenectomy.

STUDY OBJECTIVE: To show the feasibility of performing aortic lymphadenectomy with 3-mm instruments in gynecologic malignancies.

PATIENT: A 43-year-old, multiparous patient with serous ovarian cancer grading 2, Fédération Internationale de Gynécologie et d'Obstétrique stage IC (intraoperative spillage).

INTERVENTION: The patient was accidentally diagnosed with ovarian cancer after a right adnexectomy performed for an ovarian cyst. Once referred to our center, a delayed surgical staging was planned including total hysterectomy, left adnexectomy, aortic and pelvic lymphadenectomy, peritoneal biopsies, and total omentectomy. Minilaparoscopy was believed to be feasible to achieve it.

MEASUREMENTS AND MAIN RESULTS: The operation was performed successfully with no intraoperative or postoperative complication. Operative time was 150 minutes overall, and blood loss was 50 mL. Twenty-three aortic lymph nodes were removed. The pathology report came back clean. The patient was discharged on day 1 and 10 days later started adjuvant chemotherapy. After 16 months, no recurrence was detected.

CONCLUSION: Minilaparoscopy aortic lymphadenectomy is technically feasible when performed by trained surgeons.