Extraperitoneal pelvic and para-aortic lymphadenectomy.

Many laparoscopic surgeons, particularly in urology, have been performing a laparoscopic transperitoneal pelvic and para-aortic lymphadenectomy for prostatic and germ cell cancers respectively with great success. The transperitoneal route has been superceded by an extraperitoneal approach. Although the working space is sometimes a little more restricted and orientation more difficult, the ultimate result is a procedure associated with much less post-operative pain.