Surgical Film Library-Outside-in” Approach – Extraperitoneal Lymph Node Dissection With Vnotes Hysterectomy Bilateral Salpingo-oophorectomy Omentectomy for Surgical Staging of Endometrial Sarcoma

Outside-in” Approach – Extraperitoneal Lymph Node Dissection With Vnotes Hysterectomy Bilateral Salpingo-oophorectomy Omentectomy for Surgical Staging of Endometrial Sarcoma

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Video Transcription

Video Summary

This video presents a 65-year-old woman with postmenopausal bleeding diagnosed with uterine sarcoma, undergoing full staging surgery using an outside-in extraperitoneal approach due to prior hernia repair. After diagnostic laparoscopy, extraperitoneal lymph node dissection was performed bilaterally, carefully identifying key anatomical landmarks and nerves. The hysterectomy was completed via a transvaginal (V-nodes) approach, managing adhesions from previous surgeries. Omental biopsy was also done. The operation lasted 3.5 hours with minimal blood loss and no complications. Final pathology showed stage 1b low-grade uterine adenosarcoma, and the patient was advised close surveillance. The outside-in method proved safe and technically beneficial.

Asset Subtitle

Yu Hui Lim, Singapore

Meta Tag

Procedure Pelvic Lymph node dissection

Route MIS-Laparoscopic

Skill Level Expert

Surgical Location Pelvis

Keywords

MIS-Laparoscopic

Pelvis

Pelvic Lymph node dissection

Expert

uterine sarcoma

extraperitoneal lymph node dissection

postmenopausal bleeding

outside-in surgical approach

low-grade uterine adenosarcoma