Original Article Laparoscopic para-aortic lymphadenectomy: Technique and surgical outcomes Gülşen Do  gan Durda  g*, Songül Alemdaro  glu, Şafak Yılmaz Baran, Didem Alkaş Ya  gınç, Seda Yüksel Şimşek, Hüsnü Çelik Başkent University Faculty of Medicine, Adana Application and Research Hospital, Department of Gynecology and Obstetrics, Adana, Turkey A R T I C L E I N F O Article history: Accepted 16 September 2020 Available online xxx Keywords: Gynecologic cancer Laparoscopy Minimal invasive surgery Obese Para-aortic lymphadenectomy A B S T R A C T Objective: Pelvic and para-aortic lymph node dissection is an important part of staging surgery. Aim of this study is to evaluate perioperative outcomes of patients, who underwent laparoscopic para-aortic lymphadenectomy for gynecological cancer in a single center over a period of 7 years, based on body mass index (BMI), and to present the surgical technique in steps. Methods: Data of patients who underwent para-aortic lymphadenectomy at gynecological oncology department of a tertiary center in between March 2013 and July 2020 were analyzed retrospectively. Patients were evaluated in two groups according to their BMI (< 30 kg/m 2 as non-obese and  30 kg/m 2 as obese groups). Surgical technique is described in steps. Perioperative outcomes of the two groups were evaluated. Results: A total of 230 patients were included in the study. BMI was 30 at 58.46 % of the patients. Peri- operative features were not significantly affected by the patient’s BMI with the presented surgical technique, however, collected para-aortic lymph node numbers were higher in the group with BMI < 30, though sufficient number of lymph nodes were achieved in both groups. Conclusion: Although some technical difficulties may be encountered, laparoscopic para-aortic lymphadenectomy is feasable in gynecologic oncological surgery independent of BMI. However, surgical experience is important. ﾩ 2020 Elsevier Masson SAS. All rights reserved. Introduction Lymph node involvement is one of the most important factors which affect the prognosis in gynecological malignancies. [1,2]. Therefore, pelvic and/or para-aortic lymph node dissection for histopathological examination is an important part of staging surgery, and it can be performed by traditional open surgery or laparoscopy. [2]. Laparoscopic lymphadenectomy was started to be performed in the early 1990 0 s and several techniques have been described by different authors since then. In particular, the importance of surgical technique and experience is emphasized, since laparo- scopic para-aortic lymphadenectomy (PAL) is technically more difficult than pelvic lymphadenectomy. In order to improve surgical efficiency and safety, both the number and location of trocars, and the position of the surgeon, assisstants and monitor have been subject to research [1,3,4]. Aim of this study is to evaluate the perioperative data of patients, who underwent laparoscopic PAL for gynecological cancer in a single center over a period of 7 years, based on body mass index (BMI), and to present the surgical technique in steps along with the perioperative outcomes. Material and methods This study was carried out by retrospective analysis of the data of patients who underwent PAL at gynecological oncology department of a tertiary center in between March 2013 and July 2020. All patients who underwent laparoscopic PAL due to gynecological malignancy during this time interval were included in the study. Patients were evaluated in two groups according to their body mass index (BMI) (BMI < 30 kg/m 2 as non-obese and BMI  30 kg/ m 2 as obese groups). Age, surgical procedure and indication, operation duration, collected lymph node numbers, intraoperative and postoperative complications, conversion rate from * Corresponding author at: Başkent University Faculty of Medicine, Adana Application and Research Hospital, Department of Gynecology and Obstetrics, Adana, Turkey. E-mail address: gulsendogan@hotmail.com (G. Do gan Durda g). http://dx.doi.org/10.1016/j.jogoh.2020.101917 2468-7847/ﾩ 2020 Elsevier Masson SAS. All rights reserved. Journal of Gynecology Obstetrics and Human Reproduction xxx (2019) xxx–xxx G Model JOGOH 101917 No. of Pages 6 Please cite this article as: G. Do gan Durda g, S. Alemdaro glu, S. Yılmaz Baran et al., Laparoscopic para-aortic lymphadenectomy: Technique and surgical outcomes, J Gynecol Obstet Hum Reprod, https://doi.org/10.1016/j.jogoh.2020.101917 Available online at ScienceDirect www.sciencedirect.com