Robotic Resection of Diaphragm Metastases in Ovarian Cancer: Technical Aspects

Javier F. Magrina, Paul M. Magtibay

Research output: Contribution to journalArticlepeer-review


Diaphragm metastases in ovarian cancer can be safely resected robotically in selected patients. The technique is similar to laparotomy, whether it is a peritoneal or full-thickness excision. Trocar placement is very important for successful resection and is dependent on the location of the disease. Metastases involving the left diaphragm and the ventral aspect of the right diaphragm are accessed with trocars placed slightly cranial to the umbilicus. Metastases in the dorsal aspect of the right diaphragm are removed with trocars in the upper quadrants. Metastases located in the lateral portion of the right diaphragm are excised using an infrahepatic approach, and those in the medial aspect are removed using a suprahepatic approach. In peritoneal resection, monopolar instruments must be kept at 10 W to 15 W to prevent contraction of the diaphragm and pleural perforation. Intraoperative pleural decompression is performed via an aspirating catheter. A video of the technique described in this report is available online (Supplementary Video 1).

Original languageEnglish (US)
Pages (from-to)1417-1422
Number of pages6
JournalJournal of Minimally Invasive Gynecology
Issue number6
StatePublished - Sep 1 2020


  • Gynecologic malignancy
  • Metastatic disease
  • Minimally invasive surgery
  • Robotic surgery

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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