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Robotic hysterectomy with pelvic lymphadenectomy for early endometrial cancer in a patient with situs inversus totalis using 3D-CT analysis: a case report
1Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, 2-174 Edobashi, Tsu City, 514-8507 Mie, Japan
2Department of Obstetrics and Gynecology, Mie-chuo, Medical Center Hisaimyoujinchou, Tsu City, 2158-5, 514-1101 Mie, Japan
DOI: 10.31083/j.ejgo.2021.01.2294 Vol.42,Issue 1,February 2021 pp.189-192
Submitted: 02 October 2020 Accepted: 28 December 2020
Published: 15 February 2021
*Corresponding Author(s): Eiji Kondo E-mail: eijikon@clin.medic.mie-u.ac.jp
Background: Pelvic lymphadenectomy should be considered the standard of care for endometrial cancer patients with intermediate-risk. In such cases, lymph node assessment may be performed via a minimally invasive approach. Situs inversus totalis is a congenital condition wherein the major visceral organs are reversed or mirrored from their normal anatomical positions. Reports state that performing surgery on patients with this condition is difficult due to the anatomical abnormality. However, few clinical studies have been conducted to evaluate the efficacy of robotic surgery for endometrial cancer patients with situs inversus totalis because it is technically challenging. Case presentation: A 69-year-old woman with situs inversus totalis (gravida 2 para 2) was brought to our hospital due to a uterine tumor. Endometrial biopsy showed grade 1 endometrioid carcinoma. Using 3 dimensional -computed tomography reconstruction, her common iliac arteries and veins were found to be reversed or mirrored from their normal positions. She underwent hysterectomy with pelvic lymphadenectomy using the multi-articulated arms or 3 dimensional high-definite vision of the da Vinci® surgical system, and 19 lymph nodes were harvested. She was followed up for 24 months without signs of recurrence. Conclusion: The multi-articulated arms or 3 dimensional high-definite vision of the da Vinci® surgical system may be a feasible and safe approach for performing a pelvic lymphadenectomy on patients with situs inversus totalis using 3 dimensional computed tomography analysis.
Situs inversus totalis; Robotic hysterectomy; Pelvic lymphadenectomy; Early endometrial cancer
Hideaki Yajima,Eiji Kondo,Masafumi Nii,Michiko Kaneda,Kenta Yoshida,Tomoaki Ikeda. Robotic hysterectomy with pelvic lymphadenectomy for early endometrial cancer in a patient with situs inversus totalis using 3D-CT analysis: a case report. European Journal of Gynaecological Oncology. 2021. 42(1);189-192.
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