850 DA VINCI ROBOT ASSISTED VIDEO ENDOSCOPIC INGUINAL LYMPHADENCTOMY (R-VEIL) : INITIAL EXEPERIENCE

Abstract

You have accessJournal of UrologyTechnology & Instruments: Robotics: Benign & Malignant Disease (I)1 Apr 2013850 DA VINCI ROBOT ASSISTED VIDEO ENDOSCOPIC INGUINAL LYMPHADENCTOMY (R-VEIL) : INITIAL EXEPERIENCE Yuvaraja Thyavihally, Abhinav Pednekar, and Harshwardhan Pokharkar Yuvaraja ThyavihallyYuvaraja Thyavihally Mumbai, India More articles by this author , Abhinav PednekarAbhinav Pednekar Mumbai, India More articles by this author , and Harshwardhan PokharkarHarshwardhan Pokharkar Mumbai, India More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.418AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Inguinal lymphadenectomy is a well-established therapeutic option for patients with invasive penile squamous cell carcinoma who are at risk of regional metastases but with high incidence of wound related morbidity. The objective is to report the use of endoscopic robotic-assisted Video Endoscopic Inguinal Lymphadenectomy (R-VEIL) in managing the groin of patients with carcinoma of penis. METHODS We have performed five R-VEIL for three cancer penis patients in last 5 months. Two patients underwent bilateral and one patient unilateral R-VEIL. All had high grade primary tumor with clinically negative groin and in four groins, frozen section was positive for lymph node metastasis who had robotic pelvic dissection as well. Technique of R-VEIL involves a 2-cm mid-thigh incision and developing a plane just deep to Camper's (fatty) fascia by using finger dissection. After creating sufficient working space 3 robotic ports and 1 assistant port are placed, and the robotic device (Da Vinci Si HD) was docked. Inguinal triangle was dissected to the inguinal ligament superiorly, the sartorius muscle laterally, and the adductor longus muscle medially to include both superficial and deep lymph nodes in the dissection template. RESULTS Mean age of the patients was 56 years (Range 51- 65). Mean console time was 140 mts (Range 120-190) for each groin, blood loss 80 ml (Range 30-100ml). There were no intraoperative complications. None of the patient had wound related complications like necrosis, infection. Average time for lymphorrheoa to stop was 14 days. CONCLUSIONS With our initial experience with R-VEIL in selected patients, a minimally invasive approach circumventing the need for thick skin flaps, the improved flexibility afforded by robotic instruments, and the improved magnification could decrease the morbidity associated with inguinal lymphadenectomy while maintaining oncologic principles. However long term follow up with more number of cases are required. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited bySingh A, Jaipuria J, Goel A, Shah S, Bhardwaj R, Baidya S, Jain J, Jain C and Rawal S (2018) Comparing Outcomes of Robotic and Open Inguinal Lymph Node Dissection in Patients with Carcinoma of the PenisJournal of Urology, VOL. 199, NO. 6, (1518-1525), Online publication date: 1-Jun-2018. Volume 189Issue 4SApril 2013Page: e349 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yuvaraja Thyavihally Mumbai, India More articles by this author Abhinav Pednekar Mumbai, India More articles by this author Harshwardhan Pokharkar Mumbai, India More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...