The surgical technique of laparoscopic pelvic lymphadenectomy: how to streamline the procedure.

Pelvic lymphadenectomy (PL) is an important surgical procedure for patients with gynecological malignant tumors, and the status of lymph node involvement is associated with prognosis and decision-making of postoperative adjuvant treatment. The surgical approaches for PL include extraperitoneal lymphadenectomy and intraperitoneal lymphadenectomy. Laparoscopic PL (LPL) is related to better cosmetic result and faster recovery compared to abdominal PL. However, the importance of surgical techniques and experience needs to be emphasized. This video aims to describe the experience of a LPL in our institution. We reported a 52-year-old woman with stage IA endometrial carcinoma who underwent laparoscopic total hysterectomy and PL. The diagnosis for this patient was stage IA low differentiated endometrial adenocarcinoma. Therefore, a laparoscopic total hysterectomy with double appendages and PL was performed. There were 15 lymph nodes removed in the left pelvis and 13 lymph nodes removed in the right pelvis. Postoperative pathological findings suggested that endometrial hyperplasia changed, local hyperplasia was disordered, and no residual tumor was found. In addition, all of the lymph nodes were negative. PL is an important surgical procedure for gynecological malignancies. A good understanding of basic laparoscopic technique would improve the odds of a successful operation.