Robotic inguinal lymph node dissection. Surgical technique: Tips and tricks

摘要

• Inguinal lymph node dissection for treating penile cancer has undergone significant advancements. • Despite its high morbidity rate, it is a great diagnostic and therapeutic option, particularly when done early in the disease. • The introduction of minimally invasive techniques led to a reduction in the complication rate, although this remains high. Inguinal lymph node dissection (ILND) is recognized as a diagnostic and therapeutic approach used in penile cancer patients, even in those without clinically palpable nodes or radiologic evidence of metastasis. This is because 25% of patients harbor micrometastasis in the inguinal region. Despite its necessity, ILND is associated with a high complication rate, leading to multiple advancements and the development of different innovative techniques over the last decades. These include different dissection templates, saphenous vein preservation, dynamic sentinel lymph node biopsy, and minimally invasive techniques. These revolutionary practices reduced the complication rate, although it remains relatively high. In this video, we demonstrate the robotic-assisted ILND using an innovative technique in addition to many key procedural recommendations and postoperative considerations.