Single-Port Robotic Inguinal Lymph Node Dissection for Penile Cancer

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OBJECTIVE: Inguinal lymph node dissection (ILND) is an essential component in the diagnosis, management, and treatment of penile cancer. Recent advances in minimally invasive surgery may play an important role in decreasing the adverse effects and complications of lymph node dissections. We present our technique utilizing a single-port (SP) robot assisted laparoscopic bilateral ILND in a patient with pT3N2Mx penile cancer s/p partial penectomy and sentinel lymph node biopsy.

METHODS: We present a case of a 64-year-old man who underwent a radical penectomy for previously diagnosed penile cancer. Pathology report showed invasive squamous cell carcinoma of the penis. In accordance with NCCN guidelines, we performed a bilateral inguinal and pelvic lymph node dissection using robotic assisted SP laparoscopy with the DaVinci Single-Site platform. Our methods are detailed in this technical report.

RESULTS: Total operative time was 3 hours and 38 minutes in duration with minimal blood loss (<20 >mL). A 3 cm inguinal lymph node was excised and positive for malignancy without involvement of other nodes. The patient was discharged 90 minutes after recovery in PACU without narcotics and returned to normal bowel function within 6 hours.

CONCLUSION: We present a successful surgical outcome of a SP robotic ILND in treating a patient with T3N2M0 penile cancer. At the time of publication, the patient is cancer-free with no palpable lymphadenopathy on exam. Utilization of the SP DaVinci system may soon become the standard of care in select cases as it is currently the least invasive approach and is associated with lower morbidity and mortality.

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ePub ahead of print