Robot-assisted supine extraperitoneal retroperitoneal lymph node dissection: a novel approach for template dissection in post-chemotherapy residual mass in non-seminomatous germ cell tumours

Robot-assisted retroperitoneal lymph node dissection (RA-RPLND) in testicular cancer is conventionally performed through transperitoneal route. We report a case of robot-assisted supine extraperitoneal RPLND (RASE-RPLND), not previously described in the literature, which was performed for post-chemotherapy residual mass in a case of non-seminomatous germ cell tumour (NSGCT). RASE-RPLND apart from providing the benefits of robotic assistance has a significant advantage over transperitoneal approach, as the procedure can be performed in supine position without any bowel handling. Herein, we provide a detailed description of the novel surgical technique employed by us in this case.