Techniques in endourology endoscopic lymphadenectomy for penile carcinoma. Commentary

Background and Purpose: Groin dissection remains the gold standard for the treatment of penile carcinoma that has metastasized to the inguinal lymph nodes. However, it is associated with wound-related complications. Modified groin dissection offers a less-radical approach without compromising oncologic outcomes. We present our technique for endoscopic lymphadenectomy for penile carcinoma (ELPC). Patients and Methods: Eight patients with clinical stage T 2 N 0-3 M 0 penile carcinoma underwent ELPC. Preoperative Doppler ultrasound mapping of the inguinal lymph nodes and the saphenous vein was performed. Results: Fourteen lymphadenectomies, including superficial with or without deep inguinal and pelvic-node dissection, were completed in eight patients. The median operative time was 91 minutes (range 50-150 minutes), and the mean number of nodes removed was 9 (range 4-15). No perioperative complications occurred. Lymphoceles developed in three groins (23%). No wound-related complications were seen. Conclusions: The ELPC is a safe and feasible technique that appears to diminish the wound-related complications associated with the standard open approach.