Laposcopic retroperitoneal lymph node dissection: evolution of a new technique.

Retroperitoneal lymph node dissection is the most accurate method of detecting occult lymph node metastases in the retroperitoneum. In clinical stage II disease, a residual tumor after primary chemotherapy has to be removed surgically. For these two indications we have replaced open surgery by laparoscopy, in order to reduce morbidity. Once the learning curve had been overcome, the operative time was in the range of that of open surgery, and from the very beginning morbidity and complication rates were lower. Oncologic long-term outcome was not compromised by the laparoscopic approach. Patient satisfaction was very high.