title: Video Endoscopic Inguinal Lymphadenectomy (VEIL)--a prospective critical perioperative assessment of feasibility and morbidity with points of technique in penile carcinoma.
abstract: BACKGROUND
  Inguinal lymph node involvement is an important prognostic factor in penile cancer. Inguinal lymph node dissection allows staging and treatment of inguinal nodal disease. However, it causes morbidity and is associated with complications, such as lymphocele, skin loss and infection. Video Endoscopic Inguinal Lymphadenectomy (VEIL) is an endoscopic procedure, and it seems to be a new and attractive approach duplicating the standard open procedure with less morbidity. We present here a critical perioperative assessment with points of technique.
  
  
  METHODS
  Ten patients with moderate to high grade penile carcinoma with clinically negative inguinal lymph nodes were subjected to elective VEIL. VEIL was done in standard surgical steps. Perioperative parameters were assessed that is - duration of the surgery, lymph-related complications, time until drain removal, lymph node yield, surgical emphysema and histopathological positivity of lymph nodes.
  
  
  RESULTS
  Operative time for VEIL was 120 to 180 minutes. Lymph node yield was 7 to 12 lymph nodes. No skin related complications were seen with VEIL. Lymph related complications, that is, lymphocele, were seen in only two patients. The suction drain was removed after four to eight days (mean 5.1). Overall morbidity was 20% with VEIL.
  
  
  CONCLUSIONS
  In our early experience, VEIL was a safe and feasible technique in patients with penile carcinoma with non palpable inguinal lymph nodes. It allows the removal of inguinal lymph nodes within the same limits as in conventional surgical dissection and potentially reduces surgical morbidity.
authors: Department of Surgery, CSM Medical University (Formerly King George's Medical University), 226003, Lucknow UP, India. pahwakgmu@yahoo.co.in
authors: Harvinder Singh
authors: HS
authors: Pahwa
authors: Sanjeev
authors: S
authors: Misra
authors: Awanish
authors: A
authors: Kumar
authors: Vijay
authors: V
authors: Kumar
authors: Akash
authors: A
authors: Agarwal
authors: Rohit
authors: R
authors: Srivastava
mesh_terms: D000328:Adult; D004724:Endoscopy / Q000379:methods*; D005240:Feasibility Studies; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009367:Neoplasm Staging; D010412:Penile Neoplasms / Q000473:pathology / Q000601:surgery*; D019990:Perioperative Care; D011379:Prognosis; D011446:Prospective Studies; D020535:Video-Assisted Surgery / Q000379:methods*