Robotic Pelvic and Aortic Lymphadenectomy for Endometrial Cancer: The Console Surgeon's Perspectives on Surgical Technique and Directing the Assistant

Objective: Our purpose is to describe and demonstrate basic console dissection techniques in robotic hysterectomy, aortic and pelvic lymphadenectomy for endometrial carcinoma, and efficient methods to direct the assistant. Methods: The operating room and patient are prepared as previously detailed. Adequate exposure is the key to a successful procedure, and a skilled bedside assistant is essential in developing the dissection. Clear communication between the console surgeon and assistant plays a critical role. In addition, proper use of the robotic fourth arm allows additional retraction and permits smooth case progression. Results: We have completed more than 120 robotic hysterectomies, pelvic-aortic lymphadenectomies for endometrial cancer with these key steps. Conclusions: A systematic routine and effective use of the bedside assistant is essential for successfully completing robotic hysterectomy and aortic and pelvic lymphadenectomy. This manuscript and video illustrates our method emphasizing an efficient and comprehensive technique for this procedure.