Systematic (complete) para-aortic lymphadenectomy: Description of a novel surgical classification with technical and anatomical considerations

The clinical indications for a complete para-aortic lymphadenectomy in the surgical management of gynaecological malignancies remain controversial. The debate on complete para-aortic node dissection is hindered by the absence of an identifiable and accepted definition for the procedure of systematic (complete) para-aortic node dissection. In this paper we propose a classification of para-aortic lymphadenectomy. We have identified and imaged the most common and rare para-aortic vascular anomalies that we have encountered. An understanding of the anatomical anomalies in this area also provides a useful reference for the surgical technique that is adopted in order to ensure the completeness of excision. © 2011 RCOG.