Robotic-assisted laparoscopic surgery is the most common approach for the treatment of early-stage endometrial and
cervical cancers in the US. Surgical staging requires pelvic and often aortic
lymphadenectomy, depending on the primary
tumor characteristics. Pelvic and aortic
lymphadenectomy procedures may also be indicated for debulking of larger
metastases to improve disease control. The infra-renal basin is an important anatomic site of
metastasis from pelvic
tumors, and robotic dissection techniques for this site have been described. In recent years, sentinel lymph node (SLN) mapping has been adopted into the National Comprehensive
Cancer Network guidelines' surgical algorithm for uterine and
cervical cancers. SLN mapping has higher sensitivity for the detection of nodal
metastasis, despite removing fewer lymph nodes, and potentially reduces morbidities such as lower extremity
lymphedema. This article reviews current robotic pelvic and para-aortic
lymphadenectomy dissection techniques for endometrial and
cervical cancers and discusses the recent integration of pelvic SLN mapping in the surgical algorithm.