title: The first leg video endoscopic groin lymphadenectomy in vulvar cancer: A case report.
abstract: BACKGROUND
  The current management of vulvar cancer depends on the extension of disease, and includes primary tumor resection with safety margin as well as inguinofemoral lymph node staging. We report the case of the first leg videoendoscopic inguinal lymphadenectomy performed in a woman with a squamous cell vulvar carcinoma.
  
  
  METHODS
  A 74 years old female referred to our institution complaining of vulvar mass associated with bleeding and swelling from external genitals, vaginal burning sensation and dysuria for 5 months. A vulvar-vaginal examination under narcosis reported a right major labium lesion of 5cm with an irregular and ulcerated surface, easily bleeding on palpation, involving anteriorly the clitoral region and with a histological finding of a poorly differentiated squamous cell invasive carcinoma of the vulva ulcerating the surface epithelium. We performed, after adequate informed consent, a radical vulvectomy with a standard right inguinofemoral lymphadenectomy and a contralateral simultaneous video endoscopic inguinal lymphadenectomy-Leg procedure.
  
  
  CONCLUSIONS
  Our minimally invasive VEIL-Leg approach, performed for the first time in literature in a woman with vulvar cancer, could reduce the presence of high risk factors represented by surgical incision and by procedure-related complications, including wound infection and breakdown, hematoma, cellulitis and hernia formation.
  
  
  CONCLUSIONS
  A multicenter prospective randomized study will be helpful to clarify how this procedure could replace the standard laparotomic approach to inguinal lymphadenectomy in the vulvar cancer treatment and staging.
authors: Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy. Electronic address: naldini.angelica@gmail.com.
authors: Angelica
authors: A
authors: Naldini
authors: Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
authors: Cristiano
authors: C
authors: Rossitto
authors: Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
authors: Andrea
authors: A
authors: Morciano
authors: Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
authors: Giovanni
authors: G
authors: Panico
authors: Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
authors: Giuseppe
authors: G
authors: Campagna
authors: Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
authors: Pierluigi
authors: P
authors: Paparella
authors: Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
authors: Giovanni
authors: G
authors: Scambia
keywords: VEIL; Video endoscopic inguinal lymphadenectomy; Vulvar cancer; Vulvectomy