V02-11 SINGLE-PORT ROBOTIC ASSISTED LAPAROSCOPIC BILATERAL INGUINAL LYMPH NODE DISSECTION

e17027 Background: Vulvar carcinoma is a rare gynecologic malignancy which has seen a considerable evolution in surgical techniques over the last several decades. However, the morbidity associated with inguinal lymph node dissections remains significant. The majority of patients undergoing full lymphadenectomy will have some complication, with wound breakdown being the most common. In males, robotic inguinal lymph node dissection has been described for penile cancer. This report represents a first use of near-infared fluorescence for sentinel inguinal lymph node mapping, and the first description of complete robotic inguinal lymph node dissection for patients with vulvar malignancies. Methods: Bilateral robotic-assisted inguinal lymph node mapping and and lymphadenectomy was performed using the daVinci Xi system with a near-infared fluourescence. Results: The patient presented at 81 years old with a 3 cm lesion on the left labia. In the operating room, the vulvar lesion was injected circumferentially with indocyanine green. A 1 cm incision was made in the skin over the apex of the left femoral triangle carried past the underlying campers fascia. The tissue plain was developed overlying the femoral triangle using a tissue expander balloon. Under visual guidance, an 8 mm camera port and two 8 mm instrument ports were placed and the robot docked. The ipsilateral sentinel lymph nodes were identified using near-infared fluorescence and resected. We then performed a complete left superficial inguinal lymph node dissection. The right side was then performed in identical fashion. No sentinel node was identified on the right side. Radical hemivulvectomy was then performed without difficulty. All 11 lymph nodes were negative for disease. She was returned to the OR once for replacement of her JP drains. Her postoperative course was otherwise unremarkable and she is currently 15 months postoperative without complications or recurrence. Conclusions: Sentinel lymph node mapping and superficial inguinal lymph node dissection using robotic-assisted techniques and near-infared fluorescence is feasible and warrants further investigation.

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Single-Port Robotic Inguinal Lymph Node Dissection for Penile Cancer

Urology ◽

10.1016/j.urology.2021.12.007 ◽

2021 ◽

Author(s):

Victor A. Abdullatif ◽

Jared Davis ◽

Chase Cavayero ◽

Andrew Toenniessen ◽

Ryan J. Nelson

Keyword(s):

Lymph Node ◽

Lymph Node Dissection ◽

Penile Cancer ◽

Single Port ◽

Inguinal Lymph Node ◽

Node Dissection ◽

Inguinal Lymph Node Dissection

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Robotic-Assisted Video Endoscopic Inguinal Lymphadenectomy in Carcinoma Vulva: Our Experiences and Intermediate Results

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000000854 ◽

2016 ◽

Vol 27 (1) ◽

pp. 159-165 ◽

Cited By ~ 9

Author(s):

Vandana Jain ◽

Rupinder Sekhon ◽

Shveta Giri ◽

Nahida Hassan ◽

Kanika Batra ◽

...

Keyword(s):

Lymph Node ◽

Lymph Nodes ◽

Lymph Node Dissection ◽

Inguinal Lymph Node ◽

Node Dissection ◽

Inguinal Lymph Node Dissection ◽

Open Procedure ◽

Robotic Assisted ◽

Inguinal Lymphadenectomy ◽

The Mean

ObjectivesTo describe the technique of robotic-assisted video endoscopic inguinal lymphadenectomy (R-VEIL) in patients with carcinoma vulva and discuss the advantages of the technique and oncological outcome.MethodsTwelve patients of squamous cell cancer of vulva underwent 22 R-VEIL procedures from February 2011 to February 2015. Their preoperative, intraoperative, and postoperative data were retrospectively analysed.ResultsThe mean age of patients was 61 years (range, 32–78 years). The mean operative time was 69.3 minutes (range, 45–95 minutes). The mean blood loss was 30 mL (range, 15–50 mL). No intraoperative complication was observed. The mean drain output was 119 mL (range, 50–250 mL), and the drains were removed at a mean of 13.9 days (range, 8–38 days). The average number of superficial and deep inguinofemoral lymph nodes retrieved was 11 (range, 4–26). Two patients had positive lymph nodes on histopathology (16.67%). Postoperative complications were lymphocele (6 groins), chronic lower limb lymphedema (6 cases), prolonged lymphorrhea (1 groin), and cellulitis (2 groins). Over a follow-up period ranging from 7 to 67 months, 1 patient developed recurrence in the inguinal nodes and died 7 months after the recurrence.ConclusionsThe R-VEIL allows the removal of inguinal lymph nodes within the same limits as the open procedure for inguinal lymph node dissection and has a potential to reduce the surgical morbidity associated with the open procedure. Long-term oncological results are not available though our initial results appear promising. Prospective multi-institutional studies are required to prove its efficacy over open inguinal lymph node dissection.

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