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

• Published in: International journal of gynecological cancer Vol. 27; no. 1; pp. 159 - 165
• Main Authors: Jain, Vandana, Sekhon, Rupinder, Giri, Shveta, Hassan, Nahida, Batra, Kanika, Shah, Swati H, Rawal, Sudhir
• Format: Journal Article
• Language: English
• Published: United States BMJ Publishing Group LTD 01.01.2017
• Subjects: Adult; Aged; Carcinoma, Squamous Cell - diagnostic imaging; Carcinoma, Squamous Cell - surgery; Endoscopy; Endoscopy - methods; Female; Humans; Lymph Node Excision - methods; Lymph Nodes - diagnostic imaging; Lymph Nodes - surgery; Lymphatic Metastasis; Lymphatic system; Middle Aged; Retrospective Studies; Video-Assisted Surgery - methods; Vulvar Neoplasms - diagnostic imaging; Vulvar Neoplasms - surgery
• ISSN: 1048-891X; 1525-1438
• DOI: 10.1097/IGC.0000000000000854

To 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. Twelve 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. The 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. 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.