Extraperitoneal robot-assisted laparoscopic retroperitoneal lymph node dissection for early-stage testicular nonseminomatous germ cell tumors: A case report and literature review.

RATIONALE

Typically robot-assisted laparoscopic retroperitoneal lymph node dissection (R-RPLND) has been performed via a transperitoneal approach. Herein we report the first case of a novel R-RPLND using an extraperitoneal approach.

PATIENT CONCERNS

A 38-year-old man presented with an enlarging right scrotal mass.

DIAGNOSES

Scrotal ultrasonography demonstrated a 5.5-cm solid mass of the right testis. The patient underwent right radical inguinal orchiectomy. Pathologic examination demonstrated a mixed germ cell tumor, predominately embryonal carcinoma with yolk sac tumor.

INTERVENTIONS

Extraperitoneal R-PRLND was performed 3 weeks after the radical orchiectomy.

OUTCOME

The final pathologic examination showed a count of 19 lymph nodes, all of them negative. Normal antegrade ejaculation returned within 4 weeks postoperatively. No retroperitoneal recurrence or elevation of tumor marker levels were seen via surveillance imaging.

LESSONS

Our study shows that extraperitoneal R-RPLND is a safe and feasible procedure using an extraperitoneal approach that provides minimal invasion and rapid recovery of patients.