LAUSR

A 65yearold patient presented with endometrial adenocarcinoma G2, myometrial invasion >50%, and enlarged precaval (6×3 cm) and retrocaval (3×1.5 cm) lymph nodes up to the level of the renal veins on computed tomography. Clinical stage was cT1bN2M0, IIIC2. According to the Russian guidelines on the treatment of uterine malignancy, surgery is the treatment of choice for these patients. Total hysterectomy with pelvic and paraaortic lymphadenectomy was planned. Left extraperitoneal laparoscopic paraaortic lymphadenectomy for cervical cancer was first described by Dargent et al. The feasibility and advantages of this approach as a staging procedure for gynecologic malignant tumors have been shown in different studies. 3 However, the standard left extraperitoneal approach provides limited access to the paracaval and retrocaval areas, so the right extraperitoneal approach was used for this patient. Video 1 describes the benefits and feasibility of dissection of precaval and retrocaval bulky nodes by the right extraperitoneal laparoscopic approach. The right extraperitoneal access was created in the same way as from the left side. After placement of a 10 mm balloon trocar, the pneumoextraperitoneum was created; 5 mm and 12 mm trocars were then placed on the right anterior axillary line and the right midclavicular line. The main part of the surgery was performed with ultrasonic scissors. Using blunt dissection and