Standardized and Simplified Extended Pelvic Lymph Node Dissection During Robot-assisted Radical Prostatectomy: The Monoblock Technique

Mattei, C. Würnschimmel, P. Grande, G.B. Di Pierro

Prof. Mattei and his colleagues demonstrate the "monoblock" technique for extended pelvic lymphadenectomy (EPLND) during robot-assisted radical prostatectomy. This procedure is performed in order to obtain a single tissue monoblock from each side that contains all lymph nodes within the ePLND template, which is defined as follows:

cranially: the crossing of the ureter with the common iliac artery
caudally: the femoral canal
medially: the medial border of the external iliac artery
laterally: the internal iliac artery

This approach offers a good overview of the surgical field at all times. Due to its standardization into 10 steps, this technique is remarkable simple and still allows complete resection of all lymph nodes in the template. Spreading of fatty and lymphatic tissue into the abdominal cavity is prevented by keeping all lymphatics in one tissue block during surgery ("monoblock")

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