Robotic Resection of Diaphragm Metastases in Ovarian Cancer: Technical Aspects

Publication date: Available online 7 January 2020Source: Journal of Minimally Invasive GynecologyAuthor(s): Javier F. Magrina, Paul M. MagtibayAbstractDiaphragm metastases in ovarian cancer can be safely resected robotically in selected patients. The technique is similar to the laparotomy approach, whether it is a peritoneal or full-thickness excision. Trocar placement is very important for successful resection and is dependent on the location of the disease. Metastases involving the left diaphragm and the ventral aspect of the right diaphragm are accessed with trocars placed slightly cranial to the umbilicus. Metastases in the dorsal aspect of the right diaphragm are removed with trocars in the upper quadrants. Metastases located in the lateral portion of the right diaphragm are excised through an infrahepatic approach, and those in the medial aspect are removed through a suprahepatic approach. In peritoneal resection, monopolar instruments must be kept at 10 W to 15 W to prevent contraction of the diaphragm and pleural perforation. Intraoperative pleural decompression is performed via an aspirating catheter. A video of the technique described in this report is available online (Supplementary Video).

Source: Journal of Minimally Invasive Gynecology - January 7, 2020 Category: OBGYN Source Type: research