Authors

T.Alhameedi1  B. Maaqbeh1  M. Murad1  M. Daas1 A. Alani1 A. Al Shati1 S. Nasser2 M. Alazzam3 

1 The University of Jordan, Amman, Jordan
2 Charite Comprehensive Cancer Centre, Berlin, Germany
3 Oxford University Hospitals, Oxford, United Kingdom

Aim 

To describe a standardized technique for inguinofemoral lymph nodes dissection in vulvar cancer surgery.

Methods

A video demonstrating the dissection technique for inguinofemoral lymph nodes dissection, focusing on anatomical landmarks in a step-by-step approach, which are reproducible and easy to teach leading to surgical consistency and a decreased risk of perioperative complications.

Step-by-Step technique

1) Identification and planning skin incision based on fixed bone landmarks. 2) Careful dissection of the subcutaneous fat and identification of the anatomical dissection boundaries.3) Dissection of the superficial inguinal lymph nodes from lateral to medial aspect in a systematic fashion with preservation of the great saphenous vein. 4) Dissection of the deep inguinal lymph nodes along the femoral vein. 5) Placement of drain with tip how to reduce risk of falling and vessel protection closure with skin closure.

Conclusion

Standardized surgical techniques are essential elements for the training and reproduction of measurable outcomes. Meticulous incision planning and careful, dissection coupled with good wound closure, leads to decrease in postoperative complications. This technique provides an example of all three.