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Saphenous-sparing laparoscopic inguinal lymphadenectomy.

Gaetano Chiapparrone1, Sebastiano Rapisarda2, Bernardino de Concilio2

  • 1Department of Urology, Ospedale do Cattinara, Trieste - Italy.

International Braz J Urol : Official Journal of the Brazilian Society of Urology
|October 25, 2017
PubMed
Summary

Video endoscopic inguinal lymphadenectomy (VEIL) offers a minimally invasive approach for penile cancer management. This technique shows promise in reducing complications associated with traditional inguinal lymphadenectomy.

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Area of Science:

  • Oncology
  • Surgical Innovation
  • Minimally Invasive Surgery

Background:

  • Inguinal lymphadenectomy is crucial for penile cancer staging and treatment.
  • Traditional methods are associated with significant postoperative complications.
  • Video endoscopic inguinal lymphadenectomy (VEIL) is an emerging minimally invasive alternative.

Observation:

  • A 62-year-old male with penile cancer (pT1b) underwent glansectomy.
  • Clinical staging indicated a single detectable inguinal lymph node (cN1) with no distant metastasis.
  • VEIL was performed using a 10-mm optical trocar and two 5mm operating trocars.

Findings:

  • The procedure involved removal of superficial and deep inguinal lymph nodes.
  • Operative time averaged 90 minutes per side.
  • A total of 16 lymph nodes were removed, with 2 superficial positive nodes identified on the left side.
  • The patient experienced an 8-day hospital stay with no postoperative complications and drains removed on postoperative day 7.

Implications:

  • VEIL demonstrates a lower complication rate compared to traditional inguinal lymphadenectomy (ILND).
  • Saphenous-sparing techniques in VEIL further reduce risks of lymphorrhea, skin necrosis, and wound complications.
  • VEIL is a safe and effective treatment option for penile cancer when performed by experienced laparoscopic surgeons.