LAPAROSCOPIC APPROACH TO RETROPERITONEAL LYMPH-NODE DISSECTION

Laparoscopic retroperitoneal lymph node dissection is a new surgical p rocedure used to enhance staging in men with clinical stage I non-semi nomatous germ cell tumors of the testis. The procedure has been perfor med in a limited number of patients at several centers with extensive laparoscopic experience. Laparoscopic retroperitoneal lymphadenectomy is a technically demanding procedure which can be successfully complet ed in the majority of patients. However, the risk of complications is greater than in patients who undergo standard open retroperitoneal lym ph node dissection. The primary advantage of a laparoscopic approach i s shortened hospitalization and rapid return to normal activity. The r ole of laparoscopy in the management of patients with testis malignanc y has not been defined. The use of this staging procedure may help min imize the need for surveillance studies following surgery and may be b est utilized in men with a lower likelihood of nodal metastases. Ultim ately, prospective study in large groups of patients will be necessary to determine the role of laparoscopic retroperitoneal lymph node diss ection in patients with testis cancer. (C) 1996 Wiley-Liss, Inc.