Laparoscopic infrarenal paraaortic lymph node dissection for restaging of carcinoma of the ovary or fallopian tube

BACKGROUND: The purpose of the study was to investigate the feasibility of laparoscopic paraaortic lymphadenectomy in the restaging of ovarian carcinomas. METHODS: Nine patients in a referral center seen initially with ovarian (eight patients) or tubal (one patient) carcinoma who had experienced substandard staging during a previous laparotomy or laparoscopy underwent laparoscopic paraaortic lymphadenectomy as part of a surgical staging procedure that included peritoneal fluid sampling and multiple staging biopsies. Omentectomy, appendectomy, pelvic lymphadenectomy, contralateral salpingo-oophorectomy, salpingectomy, or laparoscopically assisted total vaginal hysterectomy was performed during the same operative session when necessary. RESULTS: All nine lymphadenectomies up to the level of the renal veins were successfully completed. The postoperative periods were uneventful, with an average postoperative stay of 2.8 days. CONCLUSIONS: Laparoscopic surgery may be an acceptable procedure for paraaortic lymph node sampling, sparing the patient a restaging laparotomy.