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

Abstract

The 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.

Video Endoscopic Inguinal Lymphadenectomy: Refi ning surgical technique after ten years experience

“…To improve this aspect, we indicate to increase the use of clipping to control small vessels, visualized by laparoscopic magnifi ed vision. As an adjuvant maneuver, biological glue can be used to reduce lymphatic drainage, as demonstrated in other studies of groin dissection [9][10][11][12][13].…”

“…Recently, some reports of robotic VEIL emerged with good results [10]. Excellent ergonomics and magnifi cation are the supposed benefi ts.…”

“…Reduction of lymphatic events was not demonstrated in this preliminary reports due to the small number of related events which are probably explained by the relatively low practice and the indiscriminate use of energy to seal lymphatic vessels [8][9][10][11][12][13]. To improve this aspect, we indicate to increase the use of clipping to control small vessels, visualized by laparoscopic magnifi ed vision.…”

“…Inguinal nodal involvement is found in 20% to 40% of cases at diagnosis and nodal metastasis is an important predictive factor for survival [2,3]. Metastatic penile carcinoma has an extremely poor prognosis, since reported results of systemic therapy have been disappointing, even when improvement is achieved [4][5][6][7][8][9][10][11][12].…”

Limiting the morbidity of inguinofemoral lymphadenectomy in vulvar cancer patients; a review

“…Until now, there is limited English literature on vulvar cancer. Four studies concerning VEIL in vulvar cancer patients were included in this review [32,37,39,40]. These studies were published between 2011 and 2017, two were prospective and two retrospective.…”