{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T13:09:20Z","timestamp":1774962560893,"version":"3.50.1"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T00:00:00Z","timestamp":1761609600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T00:00:00Z","timestamp":1761609600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Urology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Nerve\u2010sparing techniques are commonly used in retroperitoneal lymph node dissection (RPLND) for patients with testicular cancer to preserve postoperative ejaculation. Laparoscopic RPLND is applicable to small residual masses; however, nerve\u2010sparing techniques remain challenging. This study aimed to establish a safe, bilateral nerve\u2010sparing laparoscopic RPLND via the transperitoneal approach. The technique was developed through cadaveric surgical training (CST) and applied clinically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Thiel\u2010fixed human cadavers were used for CST. In patients with testicular cancer after chemotherapy, laparoscopic RPLND was performed based on normalized tumor markers, typically with a residual mass of 5\u2009cm or less. Patients were placed in the lateral position, and four to six ports were used, including the umbilical port; central ports were shared bilaterally. The dissection extent followed a bilateral full\u2010template approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In CST, lumbar splanchnic nerves were identified and preserved, supporting the clinical feasibility of laparoscopic RPLND. The bilateral nerve\u2010sparing laparoscopic RPLND was performed in 10 patients: 6 with non\u2010seminoma and 4 with seminoma. The mean pre\u2010chemotherapy tumor diameter was 2.7\u2009cm (range, 1.2\u20135.6\u2009cm). The mean blood loss was 165\u2009mL (range, 0\u2013540\u2009mL). The bilateral lumbar splanchnic nerves were preserved in all cases, and postoperative ejaculatory function was confirmed to be preserved in 9 cases. Surgical complications included Grade 1 chyle leakage in 5 patients, all of whom improved with conservative management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A laparoscopic bilateral nerve\u2010sparing RPLND technique was developed to achieve both minimal invasiveness and preservation of ejaculatory function. Long\u2010term follow\u2010up is necessary to confirm oncological outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/iju.70267","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T00:47:50Z","timestamp":1761698870000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Laparoscopic Bilateral Nerve\u2010Sparing Retroperitoneal Lymph Node Dissection for Testicular Cancer After Chemotherapy"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8409-5152","authenticated-orcid":false,"given":"Koji","family":"Hatano","sequence":"first","affiliation":[{"name":"Department of Urology The University of Osaka Graduate School of Medicine  Suita 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