J Robot Surg. 2010 Aug;4(2):129-32. doi: 10.1007/s11701-010-0189-8. Epub 2010 Jun 11.
Robotic pelvic lymphadenectomy is a well established procedure in the urologic and gynecologic literature. To our knowledge robotic pelvic lymphadectomy for metastatic melanoma has yet to be described. Herein we present the first report of robot-assisted pelvic lymphadenectomy in malignant melanoma. After placement of six laparoscopic ports (12 mm camera, three 8-mm robotic ports, 12-mm and 5-mm assistant ports) the DaVinci S robot (Intuitive Surgical, CA, USA) was docked in standard fashion with the patient in low lithotomy. In both cases the patients had enlarged pelvic lymph nodes on computed tomography and complete excision of these masses was accomplished along with complete lymphadenectomy extending from Cooper's ligament to just below the hypogastric artery in case 1 and to level of the bifurcation of aorta in case 2. A PK Maryland Dissector and monopolar scissors were used for dissection. Both patients were discharged on postoperative day #1. Robotic pelvic lymphadenectomy can be safely used for management of patients with metastatic melanoma involving the pelvic lymph nodes. Compared with the standard open procedure, pelvic lymphadenectomy with robotic assistance is associated with excellent vision and minimum morbidity.
机器人盆腔淋巴结切除术在泌尿科和妇科文献中已得到广泛认可。据我们所知，机器人辅助盆腔淋巴结切除术在转移性黑色素瘤中尚未得到描述。在此，我们首次报道了机器人辅助盆腔淋巴结切除术治疗恶性黑色素瘤。在放置六个腹腔镜端口（12mm 摄像头、三个 8mm 机器人端口、12mm 和 5mm 辅助端口）后，达芬奇 S 机器人（直觉外科，加利福尼亚州，美国）以标准方式与患者低位截石位对接。在这两种情况下，患者的盆腔淋巴结在计算机断层扫描上均有增大，并且完成了这些肿块的完全切除，同时完成了从库珀韧带到第 1 例中下腹动脉下方，到第 2 例中主动脉分叉水平的完整淋巴结切除术。使用 PK Maryland 解剖器和单极剪刀进行解剖。两名患者均在术后第 1 天出院。机器人盆腔淋巴结切除术可安全用于治疗涉及盆腔淋巴结的转移性黑色素瘤患者。与标准的开放性手术相比，机器人辅助盆腔淋巴结切除术具有出色的视野和最小的发病率。
