A new approach for accessing retroperitoneal space using a 10-mm visual access cannula

Retroperitoneal lymph node evaluation is a very important step in planning cancer therapy. Traditional staging laparotomy is too invasive and causes considerable morbidity. However, laparoscopic access of the retroperitoneal space offers the onco-endoscopist a unique, noninvasive, and less dangerous method for assessing and managing women with gynecologic malignancies. The retroperitoneal approach is noninvasive and less dangerous way of accessing the paraaortic space. A new minimally invasive approach of accessing the retroperitoneal space using a 5-mm visual access cannula is introduced. A complete paraaortic and pelvic lymphadenectomy was possible for 60 patients with varied gynecologic malignancies using our retroperitoneal laparoscopic approach. Less blood loss and rapid recovery was observed, and no bowel complication was encountered. The use of the 5-mm visual access cannula offers a less invasive surgical procedure and provides cosmetic advantages.