METODICA DI TECNICA LAPAROSCOPICA PER UNA ACCURATA LINFECTOMIA PELVICA STADIATIVA

Laparoscopic pelvic lymphadenectomy is a new less invasive procedure for prostatic and bladder tumour staging. The most important problem with this technique is staging error due to inadequate lymphadenectomy; in fact it is often difficult to entirely expose the obturator fossa. Twenty-one laparoscopic pelvic lymphadenectomies were performed and in the last 5 cases a new simple method was introduced to facilitate the exposure of obturator fossa. After peritoneum incision, two sutures of 2-0 Ti-Cron were placed by means of a laparoscope at peritoneal margins, near the ureteral crossing of the iliac vessels. These were then brought back through two 5 mm trocars placed bilaterally near McBurney's point. All obturator lymphnodes were easily visualized and removed, particularly those near the iliac vessels bifurcation.