Video-endoscopic Inguinal Lymphadenectomy Radiology and Imaging

Penile carcinoma is a rare malignant disease with a significantly higher incidence in some areas of underdeveloped countries. Inguinal nodal involvement is found in 20–40% of cases at diagnosis and nodal metastasis is an important predictive factor for survival. Although recent data demonstrated a survival benefit with immediate resection of clinically occult lymph-node metastases, surgical morbidity is still high. Videoendoscopic inguinal lymphadenectomy (VEIL) was described in the clinical arena six years ago to duplicate the open template, reducing morbidity without compromising oncological control. All technical variations described for open surgery were safe and feasible using the endoscopic approach. In terms of reproducibility, preliminary results of a worldwide survey identified that 11 centres were already performing VEIL. Reduced morbidity and good midterm oncological results are important arguments for growing acceptance of this new minimally invasive option to manage inguinal lymph nodes in high-risk penile cancer patients.