CSA Home
Central Surgical Association

Back to 2022 Abstracts


Starting A Minimally Invasive Inguinal Lymphadenectomy Program - Initial Learning Experience And Outcomes
*Mariam Tajalli Khan, *Jesse Kelley, G. Paul Wright
Spectrum Health, Grand Rapids, MI

Objective(s): Despite promising data on minimally invasive inguinal lymphadenectomy (MI ILND) indicating decreased wound complications, open lymphadenectomy remains the standard approach for surgical management of inguinal nodal metastases. In this series, we reviewed our institutional experience with MI ILND by a single surgeon.
Methods: This is a retrospective case series on consecutive patients undergoing MI ILND from August 2017 to October 2021. Patients meeting criteria for inguinal lymph node dissection were considered for MI ILND unless there was skin involvement by tumor. Data collected included patient characteristics, primary cancer, surgery, and postoperative complications. All procedures were performed videoscopically using three incisions to accommodate ports.
Results: There were 23 patients meeting study criteria. The mean age was 63.6 years (SD=14.5). Most patients were female (n=15, 65.2%), and the primary diagnosis was melanoma (n=18, 78.3%). In 5 cases (21.7%), MI ILND was combined with deep pelvic node dissection, but most patients did not have a concurrent procedure (n=16, 69.6%). The mean operative time was 164.1 minutes (SD=74.5) or 119.1 minutes, (SD=18.8) excluding MI ILND with concurrent procedures. Figure 1 shows trends in operative time. The median number of nodes retrieved was 9 (range 4-18). A positive node was identified in 17 patients (73.9%). No patients required conversion to an open procedure. Surgery was performed on an outpatient basis with same day discharge in 15 patients (65.2%). There were 13 (56.5%) patients experiencing at least one postoperative complication within 30 days of surgery, the most common being surgical site infection (n=6, 26.1%). One patient required re-operation for infected hematoma washout. Postoperative intervention for seroma was required in 5 patients (21.7%).


Conclusion: MI ILND is a safe alternative to open inguinal node dissection in terms of node retrieval and postoperative complications, with our cohort having comparable outcomes to patients in the existing literature. For surgical oncologists or general surgeons treating patients with inguinal nodal metastases and experienced with laparoscopy, MI ILND can be a valuable addition to their armamentarium.


Back to 2022 Abstracts