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Chinese Journal of Laparoscopic Surgery(Electronic Edition) ›› 2026, Vol. 19 ›› Issue (03): 135-139. doi: 10.3877/cma.j.issn.1674-6899.2026.03.003

• Specialist Forum • Previous Articles    

Application of transumbilical laparoendoscopic single-site retroperitoneal para-aortic lymphadenectomy in gynecologic malignancies

Hongtao Guo1, Yitong Ma2, Zhiqiang Yao1, Xuehan Bi1, Chang Liu1,()   

  1. 1Department of Obstetrics and Gynecology, the First Hospital of Lanzhou University, Gansu Provincial Clinical Research Center for Gynecological Oncology, Branch of National Clinical Research Center for Gynecology and Obstetrics, 730000, China
    2The First Clinical Medical College, Lanzhou University, 730000, China
  • Received:2026-05-15 Online:2026-06-30 Published:2026-08-12
  • Contact: Chang Liu

Abstract:

Para-aortic lymphadenectomy is an important component of surgical staging and regional lymph node assessment in gynecologic malignancies. The extent and quality of lymph node dissection directly affect staging accuracy and subsequent treatment decisions. Conventional laparotomy is associated with greater surgical trauma, whereas the transperitoneal multiport laparoscopic approach may be limited by bowel interference, omental obstruction, obesity, and other factors during dissection of the upper para-aortic region, resulting in suboptimal surgical exposure.The retroperitoneal approach facilitates exposure and dissection of high-level para-aortic lymph nodes. Meanwhile, transumbilical laparoendoscopic single-site surgery offers the advantages of minimal invasiveness and superior cosmetic outcomes. The combination of these two approaches has led to the development of transumbilical laparoendoscopic single-site retroperitoneal para-aortic lymphadenectomy, which reduces abdominal wall trauma while preserving the anatomical advantages of retroperitoneal access, thereby providing a novel minimally invasive option for surgical staging in gynecologic malignancies. Based on current evidence and clinical experience, this review summarizes the developmental background, technical characteristics, indications, standardized surgical procedures and key operative techniques, clinical value, and future perspectives of this procedure, with the aim of providing a reference for its standardized implementation and wider clinical application.

Key words: Laparoendoscopic single-site surgery, Transumbilical approach, Retroperitoneal approach, Para-aortic lymphadenectomy, Gynecologic malignancies, Minimally invasive surgery

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