Clinical Application of Endoscopic Inguinal Lymph Node Resection after Lipolysis and Liposuction for Vulvar Cancer

Abstract

Aim: To examine lymph nodes obtained after lipolysis and liposuction of subcutaneous fat of the inguinalregion of female vulvar cancer patients to explore the feasibility of clinical application. <br/><b>Methods</b>: The field ofoperation was on the basis of the range of the conventional resection of inguinal lymph nodes. We injected lipolysisliquid fanwise, started liposuction after 15-20 minutes; then the subcutaneous fatty tissue was sucked out clearlyby suction tube. We selected the first puncture holes located on 2-3 cm part below anterior superior spine, theothers respectively being located 3cm and 6cm below the first for puncturing into the skin, imbedding a trocarto intorduce CO₂ gas and the specular body, and excise the lymph nodes by ultrasonic scalpel. The surgicalfield chamber was set with negative pressure drainage and was pressured with a soft saline bag after surgery.<br/><b>Results</b>: A lacuna emerged from subcutaneous of the inguinal region after lipolysis and liposuction, with a widefascia easily exposed at the bottom where lymph nodes could be readily excised. The number of lymph nodesof ten patients excised within the inguinal region on each side was 4-18. The excised average number of lymphnodes was 11 when we had mature technology. <br/><b>Conclusion</b>: Most of adipose tissue was removed after lipolysisand liposuction of subcutaneous tissue of inguinal region, so that the included lymph nodes were exposed andeasy to excise by endoscope. This surgery avoided the large incision of regular surgery of inguinal region, theresults indicating that this approach is feasible and safe for used as an alternative technology.