Preventing Complications: Video Assisted Modified Inguinal Lymphadenectomy in Staging Penile Cancer

  • Mário Pereira-Lourenço Serviço de Urologia, Instituto Português de Oncologia de Coimbra, Coimbra, Portugal
  • Duarte Vieira-Brito Serviço de Urologia, Instituto Português de Oncologia de Coimbra, Coimbra, Portugal
  • Ricardo Godinho Serviço de Urologia, Instituto Português de Oncologia de Coimbra, Coimbra, Portugal
  • Pedro Peralta Serviço de Urologia, Instituto Português de Oncologia de Coimbra, Coimbra, Portugal
  • Paulo Conceição Serviço de Urologia, Instituto Português de Oncologia de Coimbra, Coimbra, Portugal
  • Carlos Rabaça Serviço de Urologia, Instituto Português de Oncologia de Coimbra, Coimbra, Portugal
  • Mário Reis Serviço de Urologia, Instituto Português de Oncologia de Coimbra, Coimbra, Portugal
  • Amílcar Sismeiro Serviço de Urologia, Instituto Português de Oncologia de Coimbra, Coimbra, Portugal
Keywords: Lymph Node Excision, Penile Neoplasms, Postoperative Complications, Robotic Surgical Procedures, Urologic Surgical Procedures, Male

Abstract

Modified inguinal lymphadenectomy allows for correct staging in most cases of penile cancer without palpable inguinal lymph nodes. Currently, it is possible to reproduce the classic surgical technique by video assisted surgery, with similar oncological results and smaller rate of complications. In this article, we report the case of a patient with penile cancer subjected to a total penectomy (pT3NxMx), where bilateral video assisted modified inguinal lymphadenectomy (VMIL) was conducted, being described surgical technique of right VMIL. In this article surgical steps are described (patient positioning, blunt dissection of deep Scarpa fascia, identification of anatomical boundaries, identification of femoral vessels, identification and isolation of saphenous vein until the fossa ovalis, excision of lymph nodes and closure). The great advantage of VMIL is the reduction of post-operatory complications, particularly the low rate of wound dehiscence and lower limb edema, allowing for a much quicker recovery when compared with the classical approach.

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Published
2019-09-21
Section
Case Report