A modified incision and technique for total retroperitoneal access and lymph node dissection

Surgical assessment of aortocaval lymph nodes in patients with unresectable primary cervical cancer helps in planning radiation treatment ports. Removal of enlarged lymph nodes may also serve a therapeutic purpose in reducing the tumor load to be sterilized by radiation. An extraperitoneal dissection is considered to be superior to a transperitoneal approach, and numerous incisions to access either the upper or the lower retroperitoneum have been described. A modified supraumbilical incision and technique that provide wide bilateral exposure of the retroperitoneum from the suprarenal aorta to the obturator fossae were used in six patients.