Robotic Resection of Diaphragm Metastases in Ovarian Cancer: Technical Aspects
- Resource Type
- Authors
- Paul M. Magtibay; Javier F. Magrina
- Source
- Journal of Minimally Invasive Gynecology. 27:1417-1422
- Subject
- Adult
Dorsum
medicine.medical_specialty
Decompression
Umbilicus (mollusc)
medicine.medical_treatment
Diaphragm
Carcinoma, Ovarian Epithelial
Patient Positioning
Resection
03 medical and health sciences
Gynecologic Surgical Procedures
0302 clinical medicine
Robotic Surgical Procedures
Laparotomy
medicine
Humans
Robotic surgery
Ovarian Neoplasms
Muscle Neoplasms
030219 obstetrics & reproductive medicine
Wound Closure Techniques
business.industry
Obstetrics and Gynecology
Middle Aged
Surgical Instruments
medicine.disease
Surgery
Catheter
Abdominal Neoplasms
030220 oncology & carcinogenesis
Female
Laparoscopy
Ovarian cancer
business
- Language
- ISSN
- 1553-4650
Diaphragm metastases in ovarian cancer can be safely resected robotically in selected patients. The technique is similar to laparotomy, 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 using an infrahepatic approach, and those in the medial aspect are removed using 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 1).