Robot-assisted salvage extended pelvic lymp node dissection in prostate cancer

Introduction & Objectives: To present the case of a patient who underwent robot-assisted salvage lymph node dissection (PLND) for recurrent prostate cancer. Material & Methods: A 70-year old man had a rising prostate-specific antigen (PSA) up to 1,12ng/mL 3 years after robot-assisted radical prostatectomy (without PLND) and adjuvant radiotherapy for a pT3a Gleason 4+3 prostate cancer. Choline PET-CT identified 1 suspicious pelvic lymph node next to the left external iliac vessels. The patiënt underwent robot-assisted transperitoneal extended PLND. Results: In the video we present surgical technique of salvage PLND (only the right side is presented). Operation time was 175 minutes, estimated blood loss was 30mL. The patient suffered from transient penoscrotal oedema, which recuperated after 7 days. Of 19 lymph nodes removed, one harbored prostate cancer. Within 4 weeks after surgery, PSA dropped to < 0,03ng/mL and remains undetectable 12 months after surgery. Conclusions: In selected patients, salvage PLND can induce a durable PSA response.