EP1350 Inguinofemoral lymphadenectomy for the treatment of vulvar cancer. (1st November 2019) - Laufer, J
Abstract : Introduction/Background: Management of vulvar cancer requires a tailored approach with the objective of reducing morbidity associated with radical procedures. The compromise of regional lymph nodes remains the most important prognostic factor. The introduction of sentinel lymph node biopsy instead of total lymphadenectomy has drastically reduced the morbidity associated with the surgical procedure without compromising oncological safety. However, for tumours ≥ 4 cm and/or in case of multifocal invasive disease, inguinofemoral lymphadenectomy (IFL) by separate incisions is recommended. Superficial and deep femoral nodes should be removed. The main objective of this video is to review the surgical anatomical landmarks of the inguinofemoral region as well as useful tips of the procedure performed in a university hospital. Methodology: We hereby demonstrate the surgical technique of IFL while identifying the major anatomical landmarks in live tissue as well as in cadaveric dissection models. Surgical steps for the dissection of superficial and deep femoral nodes are shown. Special emphasis is placed on guiding the surgeon using still photographs and videos of live tissue and cadaveric dissection to optimize the understanding of the anatomy involved in this procedure. Key components of the surgery, including identification of Scarpa triangle components, vascular structures like the great saphenous vein, and recognition of the fossa ovalis, are shown. Results: The material shown in this video allows the identification of the anatomical landmarks and the step by step systematization of the IFL procedure. Conclusion: Through the use of still photographs and video, we hereby demonstrate the surgical technique as well as useful tips of IFL for the treatment of vulvar cancer. Disclosure: This procedure was performed at Pereira Rossell Hospital, a tertiary referral and educational center in Montevideo, Uruguay. The patient gave consent for the use of the surgery footage for educational purposes.