Fernando Arias, MD, FACS1, Gabriel Herrera-Almario, MD1, Lina Parra, MD1, Marcos Pozo, MD2, Natalia Cortes, MD1. 1Fundacion Santa Fe de Bogota, 2Johns Hopkins
Retroperitoneal biopsies are required in the presence of adenopathy, soft tissue mass or lesions. Traditional access requires a transperitoneal approach which increases time to recovery from surgery. The present video describes a case of iliac lymph node biopsy using a retroperitoneal single port approach.
Methods and results
A 53-year-old male presented with constitutional symptoms. The patient had a history of a treated Hodgkin lymphoma 16 years ago. A PET/CT showed an FDG avid mass posterior to the left iliac artery. A left posterior flank incision was made to access the retroperitoneal space. A hybrid multiport device was assembled. The retroperitoneal space was developed with blunt and bipolar dissection. The lymph node was identified in close proximity to the left common iliac artery and dissected from all its branches. The lymph node was removed without complications. The patient was discharged the same day of surgery and had no postoperative complications. Pathology revealed a recurrence of known Hodgkin lymphoma
Retroperitoneal single incision approach for biopsies in this area is a safe and feasible option, avoiding the peritoneal cavity and potentially enhancing recovery. This approach provides adequate visualization of key anatomic structures.