Video-endoscopic inguinal lymphadenectomy (VEIL) oncological and surgical benefits compared to open inguinal lymph node dissection (ILND).

Abstract

Penile cancer accounts for about 1% of all male cancer diagnoses in the United States. Regional lymph node involvement is strongly correlated with overall outcomes, and as such the procedure of inguinal lymph node dissection (ILND) is imperative to the diagnostic and oncologic outcomes for these patients. The current gold standard of open ILND presents challenges in mitigating detrimental postoperative sequalae such as wound complications and lymphedema, without compromising oncologic outcomes. There has been a growing interest and shift in minimally invasive (MIS) approaches to tackle the challenges seen in the open approach to ILND. Several different minimally invasive techniques such as laparoscopic video-endoscopic inguinal lymphadenectomy (VEIL) and robotic-assisted VEIL approaches have been explored and described in the literature. A systematic literature search of PubMed and Medline (OVID) literature review was performed to assess outcomes in MIS approaches to ILND in comparison to traditional open approach. Key words included penile cancer/penile neoplasms, minimally-invasive procedures, robotics, video-endoscopic, robotic-assisted, inguinal lymphadenectomy, and inguinal lymph node dissections. Studies show that MIS approaches to ILND have potential to reduce high-grade postoperative complications, operative time, and hospital stay while ensuring oncologic outcomes. Despite the learning curve associated with MIS ILND, preliminary data does suggest favorable outcomes. Prospective, randomized trials are needed to reveal the full benefit of MIS ILND compared to open ILND.