• Jie Qin, Ping Wang, Taile Jing, Debo Kong, Dan Xia, and WangShuoS.
• Department of Urology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
• Medicine (Baltimore). 2017 Dec 1; 96 (49): e8938.

RationaleTypically robot-assisted laparoscopic retroperitoneal lymph node dissection (R-RPLND) has been performed via a transperitoneal approach. Herein we report the first case of a novel R-RPLND using an extraperitoneal approach.Patient ConcernsA 38-year-old man presented with an enlarging right scrotal mass.DiagnosesScrotal ultrasonography demonstrated a 5.5-cm solid mass of the right testis. The patient underwent right radical inguinal orchiectomy. Pathologic examination demonstrated a mixed germ cell tumor, predominately embryonal carcinoma with yolk sac tumor.InterventionsExtraperitoneal R-PRLND was performed 3 weeks after the radical orchiectomy.OutcomeThe final pathologic examination showed a count of 19 lymph nodes, all of them negative. Normal antegrade ejaculation returned within 4 weeks postoperatively. No retroperitoneal recurrence or elevation of tumor marker levels were seen via surveillance imaging.LessonsOur study shows that extraperitoneal R-RPLND is a safe and feasible procedure using an extraperitoneal approach that provides minimal invasion and rapid recovery of patients.

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