Simultaneous Bilateral Surgery as a Model for Learning Video Endoscopic Inguinal Lymphadenectomy (VEIL)

Abstract

Purpose: Video Endoscopic Inguinal Lymphadenectomy (VEIL) is feasible and safe in selected patient with groin metastases. Simultaneous bilateral performance seems to improve morbidity, however it still requires standardization. This article aims to describe a standardized and planned training model for VEIL. Materials and methods: This model comprises a standardized training as follows: 1) Oral and video presentation; 2) Two groins operated by the teacher with camera manipulated by trainees; 3) Simultaneous VEIL performed by trainees. Three medical centers tested this model between January and December 2014. Perioperative, functional and oncological data are evaluated. Statistical analysis was done by using arithmetic average and Student T-test. Data were compared among expert, trainees and trained surgeons. Results: Ten groins were operated by trainees and twenty by the same trained surgeons. Demographic characteristics are in accordance with most of the reported studies. Surgical performance and oncological results of trainees and trained surgeons didn't differ significantly from the expert surgeon. Conclusions: Despite the limited number of patients, the proposed model is effective as an option for training in large scale. Potential advantages include feasibility and optimization of operative time.