ABSTRACT
Pelvic and aortic lymphadenectomy is an essential step in the staging of pelvic malignancies. It is often used to determine primary therapy, to help remove all grossly or occult positive disease, and to enable stratification of malignancies for valid comparisons of treatments, all with the purpose of optimizing survival. A transabdominal laparoscopic approach for pelvic and infrarenal aortic lymphadenectomy was first described by Querleu and colleagues for staging cervical, endometrial, and ovarian malignancies. Urologists and later gynecologic oncologists subsequently developed an extraperitoneal approach for pelvic, infrarenal aortic, and suprarenal aortic artery lymphadenectomy. Because the predominant drainage of malignancies of the cervix is to pelvic nodes, and of the endometrium and ovaries is to pelvic and aortic nodes, this chapter focuses on use of a direct extraperitoneal approach for staging or restaging cervical, uterine, and ovarian carcinomas.
