Robot-assisted post-chemotherapy retroperitoneal lymph node dissection for metastatic non-seminomatous germ cell tumors using two distinct surgical approaches: A tertiary care experience.

Objective: Robot-assisted post-chemotherapy retroperitoneal lymph node dissection (R-PC-RPLND) is increasingly used as an alternative to open surgery for metastatic testicular cancer. This study aimed to summarize the experience with lateral and supine approaches in R-PC-RPLND for metastatic non-seminomatous germ cell tumors, applied based on different clinical indications. Methods: We conducted a retrospective analysis of 42 consecutive patients who underwent R-PC-RPLND at our tertiary cancer center from May 2016 to July 2023. Patients were categorized based on the surgical approach used: lateral position (28 patients) or supine position (14 patients). Data on perioperative outcomes, complications, and oncological efficacy were assessed and reported using descriptive statistics. Results: The median patient age was 28.0 (interquartile range [IQR]: 23.5-30.5) years, and the median body mass index was 22.7 (IQR: 19.9-24.2) kg/m Conclusion: Both lateral and supine approaches for R-PC-RPLND demonstrated favorable surgical and oncological outcomes, with acceptable operative times, minimal blood loss, low complication rates, and effective oncological control. The choice between these approaches should consider patient-specific factors and surgeon expertise, allowing for tailored treatment that optimizes outcomes.