Modified Laparoscopic Inguinal Lymphadenectomy Using an Abdominal Subcutaneous Approach

Area of Science:

• Urology
• Surgical Oncology

Background:

• Inguinal lymph node metastases are critical prognostic factors in penile cancer.
• Early lymph node dissection is vital for effective penile cancer treatment.
• Laparoscopic lymphadenectomy presents advantages over open surgery, including reduced complications.

Purpose of the Study:

• To introduce and evaluate a modified laparoscopic inguinal lymph node dissection technique.
• To assess the safety and efficacy of a transabdominal subcutaneous anterograde approach.
• To demonstrate improved outcomes and complication rates compared to traditional methods.

Main Methods:

• A modified laparoscopic inguinal lymph node dissection using a transabdominal subcutaneous anterograde approach.
• Focus on preserving the great saphenous vein and standardized surgical procedures.
• Application in penile cancer patients requiring inguinal lymph node dissection.

Main Results:

• The modified laparoscopic approach demonstrated favorable outcomes.
• Low rates of complications, including wound infections (2/21) and lymphatic leakage (1/21).
• Comparable tumor control to open surgery with significantly reduced complications.

Conclusions:

• The innovative subcutaneous transperitoneal retrograde approach is safe and effective for penile cancer.
• This technique offers a minimally invasive alternative with fewer complications than open surgery.
• Optimized laparoscopic techniques, including saphenous vein preservation, are crucial for successful inguinal lymph node dissection.