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Sentinel Lymph Node Mapping by Retroperitoneal vNOTES for Uterus-Confined Malignancies: A Standardized 10-Step Approach

Published inCancers, vol. 16, no. 11, 2142
Publication date2024-06-05
First online date2024-06-05
Abstract

Background: Sentinel lymph node (SLN) mapping represents an accurate and feasible technique for the surgical staging of endometrial and cervical cancer. This is commonly performed by conventional laparoscopy or robotic-assisted laparoscopy, but in recent years, a new retroperitoneal transvaginal natural orifice transluminal endoscopic surgery (vNOTES) approach has been described and developed by Jan Baekelandt. This technique provides easy visualization of lymphatic afferent vessels and pelvic lymph nodes, early SLN assessment, and a coherent mapping methodology following the lymphatic flow from caudal to cranial. However, only a few publications have reported it. Following the IDEAL (Idea Development Exploration Assessment Long-term follow-up) framework, research concerning this technique is in Stage 2a, with only small case series as evidence of its feasibility. Its standardized description appears necessary to provide the surgical homogeneity required to move further.

Methods: Description of a standardized approach for retroperitoneal pelvic SLN mapping by vNOTES.

Results: We describe a 10-step approach to successfully perform retroperitoneal vNOTES SLN mapping, including pre-, intra-, and postoperative management.

Conclusions: This IDEAL Stage 2a study could help other surgeons approach this new technique, and it proposes a common methodology necessary for evolving through future IDEAL Stage 2b (multi-center studies) and Stage 3 (randomized controlled trials) studies.

Keywords
  • Cervical cancer
  • Endometrial cancer
  • Minimally invasive surgery
  • Sentinel lymph node
  • Transvaginal natural orifice transluminal endoscopic surgery
  • VNOTES
Citation (ISO format)
HUBER, Daniela, HURNI, Yannick. Sentinel Lymph Node Mapping by Retroperitoneal vNOTES for Uterus-Confined Malignancies: A Standardized 10-Step Approach. In: Cancers, 2024, vol. 16, n° 11, p. 2142. doi: 10.3390/cancers16112142
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Identifiers
Additional URL for this publicationhttps://www.mdpi.com/2072-6694/16/11/2142
Journal ISSN2072-6694
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Technical informations

Creation26/06/2024 11:45:04
First validation16/07/2024 11:45:50
Update time16/07/2024 11:45:50
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