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Ann Surg Oncol (2011) 18:898899 DOI 10.1245/s10434-010-1222-x
LETTER TO THE EDITOR
Lymphadenectomy for Melanoma: Toward a Videoscopic Approach
TO THE EDITORS:
We have read with great interest the article Feasibility of a Novel Approach to Inguinal Lymphadenectomy: Minimally Invasive Groin Dissection for Melanoma published in the March issue of Annals of Surgical Oncology by Delman and colleagues.1 The authors want to conrm the feasibility of the videoscopic approach to inguinal lymph node dissection in terms of radicality (number of lymph nodes) and morbidity (wound complications and lymphocele). Previous efforts to reduce morbidity after groin lymphadenectomy, such as preservation of muscle fascia and sartorious muscle transposition, seem to have no impact on postoperative morbidity.2
Briey, the videoscopic technique consists of incising the skin and the Scarpas fascia to the apex of the femoral triangle and positioning an optical trocar after nger blunt dissection. The working space was obtained through ination under endoscopic vision. Thereafter, two more trocars were placed outside the medial and lateral boundaries of the femoral triangle. A 0 camera, ultrasonic shears, and an endoscopic stapler for saphena section were used to complete inguinal lymph node dissection. Lymph nodes were en bloc extracted from the excised scar of the previous sentinel node biopsy.
The authors reported a mean operating time of 3 h, a median of...