title: Robot-Assisted Simultaneous Bilateral Radical Inguinal Lymphadenectomy Along with Robotic Bilateral Pelvic Lymphadenectomy: A Feasibility Study.
abstract: BACKGROUND
  To report the surgical technique, procedure outcomes, and feasibility of robot-assisted simultaneous bilateral radical inguinal with bilateral pelvic lymphadenectomy.
  
  
  METHODS
  Three consecutive patients of penile and urethral carcinoma with palpable inguinal lymphadenopathy who underwent robot-assisted simultaneous bilateral radical inguinal with bilateral pelvic lymphadenectomy in our institution from May 2013 to October 2015 were included in the study. Surgical technique is described and feasibility of the procedure is assessed.
  
  
  RESULTS
  Three patients aged 58, 76, and 35 years underwent robot-assisted simultaneous bilateral radical inguinal with bilateral pelvic lymphadenectomy with a mean operative duration of 453.33 minutes (range 420-490 minutes). Average blood loss was 66.66 mL (range 50-80 mL) and mean time to removal of last drain was 44.66 days (range 28-72 days). Mean lymph node yield in left inguinal region, right inguinal region, left pelvic region, and right pelvic region was 18, 14.6, 13.3, and 16.6, respectively. The perioperative period was uneventful. No skin flap-related complications were seen. One patient suffered lymphocele postoperatively, which was managed successfully with needle aspiration. One patient developed lung metastasis in follow-up and none of them had local recurrence.
  
  
  CONCLUSIONS
  Robot-assisted simultaneous bilateral radical inguinal with bilateral pelvic lymphadenectomy is feasible, safe, and may result in decreased morbidity compared to conventional open lymphadenectomy.
authors.affiliation: 1 Department of Urology, Renal Transplant & Robotics, Institute of Kidney and Urology , Medanta-The Medicity, Gurgaon, India .
authors.forename: Rajesh
authors.initials: R
authors.lastname: Ahlawat
authors.affiliation: 1 Department of Urology, Renal Transplant & Robotics, Institute of Kidney and Urology , Medanta-The Medicity, Gurgaon, India .
authors.forename: Rakesh
authors.initials: R
authors.lastname: Khera
authors.affiliation: 1 Department of Urology, Renal Transplant & Robotics, Institute of Kidney and Urology , Medanta-The Medicity, Gurgaon, India .
authors.forename: Gagan
authors.initials: G
authors.lastname: Gautam
authors.affiliation: 1 Department of Urology, Renal Transplant & Robotics, Institute of Kidney and Urology , Medanta-The Medicity, Gurgaon, India .
authors.forename: Abhay
authors.initials: A
authors.lastname: Kumar
mesh_terms: D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005240:Feasibility Studies; D006119:Groin; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery*; D008210:Lymphocele / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D061646:Operative Time; D010388:Pelvis; D010412:Penile Neoplasms / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D065287:Robotic Surgical Procedures / Q000379:methods*; D014523:Urethral Neoplasms / Q000473:pathology / Q000601:surgery*
keywords: inguinal lymphadenectomy; morbidity; penile cancer; robotic assisted videoendoscopic inguinal lymphadenectomy (RVEIL); robotic surgery