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Lymphadenectomy

Procedure

Video Endoscopic Inguinal Lymphadenectomy

Video Endoscopic Inguinal Lymphadenectomy (VEIL) is an endoscopic procedure performed on patients with penile cancer, who require radical inguinal lymphadenectomy. It seems to be a new and attractive approach duplicating the standard open procedure with less morbidity.

What happens before VEIL?

  • Dr. Raghunath and team will perform all preoperative tests to check your fitness for medical procedure. The team will review your list of existing medications. You will be asked to stop smoking and refrain from alcohol a few weeks before procedure. You will be given preoperative antibiotics 1 hr before starting the procedure.

 

What happens during the procedure?

  • The surgery will take place under general anesthesia. Dr. Raghunath will put you in supine position with thigh abduction. The video system will be placed on the opposite side to the abducted thigh, next to the your waist. Surgeon will make multiple small incisions to insert ports and then fill in CO2 gas for better inside view. After the dissection is completed, suction drain will be placed through lateral port and port incisions will be closed. Elastic compression dressing will be applied on the side of the surgery.

 

What to expect after procedure?

  • You will have a catheter for passing urine, which will be kept for 2 days. You will be kept in ICU till you gain senses and you will encouraged to move around. Oral intake will be started 12 hours after the procedure. Suction drain will be removed when the output will be less than 50 ml.

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Frequently Asked Questions

  • Who is an ideal patient for VEIL?
    This technique is indicated in patients with penile cancer, in the following situations:
    • After local treatment
    • When there is a lymph node mass less than 4cm
    • When mobile palpable lymph nodes appear in the postoperative follow-up
    • When there are risk factors for the development of inguinal metastasis (clinical stage > t1 or information regarding the initial biopsy such as histological grade > 1, lymphatic or vascular invasion)
  • What are the advantages and disadvantages of VEIL?
    The ergonomic position of the surgeon and the flexibility of manoeuvres are the great advantages of this new technique. It is safe, wound complication rate is much lower and length of hospital stay is greatly reduced with VEIL. The disadvantages are it is little costly and it is only available in high-end centres that treat penile cancer.