腹股沟淋巴结切除术是治疗外阴癌及阴茎癌的重要手术方式之一，传统开放手术容易导致皮肤切口 愈合不良、淋巴水肿等并发症发生。随着微创技术的发展，腹腔镜腹股沟淋巴结切除术在外阴癌及阴茎癌治疗中广 泛应用，并显示出良好的优势。在传统腹腔镜发展基础上，机器人手术系统应运而生，并以其独特的优势受到临床 医生的青睐。机器人辅助腹腔镜腹股沟淋巴结切除术在外阴癌及阴茎癌治疗中已应用 10 多年，研究显示其在保证 肿瘤治疗效果的同时降低了手术并发症。本文就机器人辅助腹腔镜腹股沟淋巴结切除术的发展历程及在上述两种肿 瘤中的应用做一综述。

Inguinal lymphadenectomy is one of the most important surgical methods in the treatment of vulvar cancer and penis cancer. Traditional open surgery is easy to cause complications such as poor skin incision healing and lymphedema. With the development of minimally invasive technology, laparoscopic inguinal lymphadenectomy has been widely used in the treatment of vulvar cancer and penis cancer, which has shown good advantages. On the basis of the development of traditional laparoscope, robotic surgical system came into being and has been favored by clinicians due to its unique advantages. Robot assisted laparoscopic inguinal lymphadenectomy has been used in the treatment of vulvar cancer and penis cancer for more than 10 years, showing that it could reduce surgical complications while ensuring tumor treatment effect. This article provides a review on the development of robot-assisted laparoscopic inguinal lymphadenectomy and its application in these two types of tumors.

收稿日期：2023-01-05  录用日期：2023-08-09 

Received Date: 2023-01-05  Accepted Date: 2023-08-09 

基金项目：重庆市技术创新与应用发展专项重点项目（CSTB2022TIAD-KPX0154） 

Foundation Item: Special Key Project for Technological Innovation and Application Development of Chongqing(CSTB2022TIADKPX0154) 

通讯作者：陈诚，Email：chencheng961@126.com 

Corresponding Author: CHEN Cheng, Email: chencheng961@126.com 

引用格式：李永康，梁苗，王延洲，等 . 机器人辅助腹腔镜技术在腹股沟淋巴结切除术中的应用 [J]. 机器人外科学杂志（中英文）， 2024，5（3）：489-494. 

Citation: LI Y K, LIANG M, WANG Y Z, et al.Application of robot-assisted laparoscopic technique in inguinal lymphadenectomy[J]. Chinese Journal of Robotic Surgery, 2024, 5(3): 489-494.

[1] Alkatout I, Sehuber M, Garbrecht N, et al. Vulvar cancer: epidemiology, clinical presentation, and management options[J]. International Journal of Womens Health, 2015. DOI: 10.2147/IJWH.S68979. 

[2] Protzel C, Alcaraz A, Horenblas S, et al．Lymphadenectomy in the surgical management of penile cancer[J]. European Urology , 2009, 55(5): 1075-1088. 

[3] Sievert K D, Drager D L, Kohn F M, et al. Penile cancer: diagnosis and staging[J]. Urologe-ausgabe A, 2018, 57(4): 418-422. 

[4] 中国抗癌协会妇科肿瘤专业委员会 . 外阴恶性肿 瘤诊断和治疗指南 (2021 年版 )[J]. 中国癌症杂志 , 2021, 31(6): 533-545. 

[5] Koh W J, Greer B E, Abu-Rustum N R, et al. Vulvar cancer, version1.2017: NCCN clinical practice guidelines in oncology[J].Journal of the National Comprehensive Cancer Network, 2017, 15(1): 92-120. 

[6] Chahoud J, Kohli M, Spiess P E. Management of advanced penile cancer[J].Mayo Clinic Proceeding, 2021, 96(3): 720-732. 

[7] Taussing F J. Cancer of the Vulva: an analysis of 155 cases (1911-1940) [J]．American Journal of Obstetrics ＆ Gynecology, 1940, 40(5): 764-779. 

[8] Jones G L, Jacques R M, Thompson J, et al. The impact of surgery for vulval cancer upon health-related quality of life and pelvic floor outcomes during the first year of treatment: a longitudinal, mixed methods study[J]. Psychooncology, 2016, 25(6): 656-662. 

[9] Rogers L J, Cuello M A. Cancer of the vulva[J]. International Journal of Gynecology ＆ Obstetrics, 2018, 143(Suppl 2): 4-13. 

[10] Bishoff J B, Teichman J M, Thompson I M．Endoscopic subcutaneous modified inguinal lymph node dissection (ESMIL) for squamous cell carcinoma of the penis[J]． Journal of Urology, 2003, 169(4): 78. 

[11] 卢艳 , 刘钗娥 , 姚德生 , 等．外阴癌腹腔镜下腹 股沟淋巴结清扫术的临床研究 [J]. 实用肿瘤杂志 , 2016, 31(6): 512-517． 

[12] ZHANG M, DING J, CHEN L, et al. A comparative tudy of video endoscopic inguinal lymphadenectomy and conventional open inguinal lymphadenectomy in treating vulvar cancer[J]. Journal of Minimally Invasive Gynecology, 2017, 27(9): 1983-1989． 

[13] WU Q, GONG Z, ZHAO Y , et al. Video endoscopic inguinal lymphadenectomy via 3-incision lateral approach for vulvar cancers: our preliminary outcome of 37 cases[J]. International Journal of Gynecological Cancer, 2016, 26(9): 1706-1711. 

[14] 曾维红 , 杨海坤．腹腔镜下腹股沟淋巴清扫术应用 于外阴癌手术治疗中的疗效 [J]. 数理医药学杂志 , 2018, 31(7): 971-973. 

[15] Josephson D Y, Jacobsohn K M, Link B A, et al. Robotic-assisted endoscopic inguinal lymphadenectomy [J]. Urology, 2009, 73(1): 167-170. 

[16] Jain V, Sekhon R, Giri S, et al. Robotic-assisted video endoscopic inguinal lymphadenectomy in carcinoma vulva: our experiences and intermediate results[J]. Int J Gynecol Cancer, 2017, 27(1): 159-165. 

[17] Hunter M, Kremer K, Wymore K. A first report of robot-assisted sentinel lymph node mapping and inguinal lymph node dissection, using near-infrared fluorescence in vulvar cancer[J]. Journal of Clinical Oncology, 2017, 35 (15_suppl): e17027. 

[18] Mohammad A, Hunter M I. Robot-assisted sentinel lymph node mapping and inguinal lymph node dissection using near-infrared fluorescence in vulvar cancer[J]. Journal of Minimally Invasive Gynecology, 2019, 26(5): 968-972. 

[19] 马佳佳 , 陈必良 . 达芬奇机器人腹股沟淋巴结清扫 术治疗外阴癌的临床效果与手术策略 [J]. 中华腔镜 外科杂志 ( 电子版 ), 2014, 7(3): 172-176. 

[20] 薛敏 , 叶明珠 , 曾飞．机器人辅助腹腔镜腹股沟淋 巴结清扫术在外阴癌中的应用 [J]．中华腔镜外科 杂志 ( 电子版 ), 2017, 10(5): 293-296. 

[21] 叶明珠 , 邓新粮 , 贺斯黎 , 等 . 机器人腹腔镜下腹股 沟淋巴结切除术在外阴癌治疗中的近期疗效研究 [J]. 机器人外科学杂志 ( 中英文 ), 2020, 1(1): 26-33. 

[22] 李琪 , 纪妹 , 赵曌 , 等 . 机器人手术系统在外阴癌 腹股沟淋巴清扫术中的临床应用 [J]. 中华妇产科杂 志 , 2018, 53(11): 779-782. 

[23] 李琪 . 达芬奇机器人手术系统在外阴鳞癌腹股沟淋 巴结清扫术中的临床应用研究 [D]. 郑州大学 , 2020. 

[24] 张兴保 , 邱学德 . 阴茎癌治疗的研究进展 [J]. 医学 综述 , 2019, 25(18): 3617-3621. 

[25] Heyns C F, Fleshner N, Sangar V, et al. Management of the lymph nodes in penile cancer[J]. Urology, 2010, 76(2): S43-S57． 

[26] Machado M T, Tavares A, Molina W R, et al. Comparative study between videoendoscopic radical inguinal lymphadenectomy(veil) and standard open lymphadenectomy for penile cancer: preliminary surgical and oncologic results[J]. The Journal of Urology, 2005, 173: 226. 

[27] Tobias-Machado M, Tavares A, Ornellas A A, et al. Video endoscopic inguinal lymphadenectomy: a new minimally invasive procedure for radical management of inguinal nodes in patients with penile squamous cell carcinoma[J]. The Journal of Urology, 2007, 177(3): 953-957. 

[28] Kumar V, Sethia K K. Prospective study comparing video-endoscopic radical inguinal lymph node dissection (VEILND) with open radical ILND (OILND) for penile cancer over an 8-year period[J]. Bju International, 2017, 119 (4): 530-534. 

[29] 杨京可 , 董小鑫 , 林佳伟 , 等 . 内腔镜下腹股沟淋 巴结清扫术治疗阴茎癌临床研究 [J]. 陕西医学杂 志 , 2022, 51(7): 860-862. 

[30] SHAO Y, HU X, REN S, et al. Comparison of different surgical methods and strategies for inguinal lymph node dissection in patients with penile cancer[J]. Scientific Reports, 2022, 12(1): 1-9. 

[31] Russell C M, Salami S S, Niemann A, et al. Minimally invasive inguinal lymphadenectomy in the management of penile carcinoma[J]. Urology, 2017.DOI: 10.1016/ j.urology.2017.11.010. 

[32] Bjurlin M A, Zhao L C, Kenigsberg A, et al. Novel use of fluorescence lymphangiography during robotic groin dissection for penile cancer[J]. Urology, 2017. DOI: 10.1016/j.urology.2017.05.026. 

[33] Singh A, Jaipuria J, Goel A, et al. Comparing outcomes of robotic and open inguinal lymph node dissection in patients with carcinoma of the penis[J]. The Journal of Urology, 2018, 199(6): 1518-1525. 

[34] Jindal T, Meena M. Laparoscopic and robotic video endoscopic inguinal lymphadenectomy by the lateral approach[J]. Asian Journal of Endoscopic Surgery, 2021, 14(3): 464-469. 

[35] Thyavihally Y B, Dev P, Waigankar S S, et al. Comparative study of perioperative and survival outcomes after video endoscopic inguinal lymphadenectomy (VEIL) and open inguinal lymph node dissection (O-ILND) in the management of inguinal lymph nodes in carcinoma of the penis[J]. Journal of Robotic Surgery, 2021, 15(6): 905-914. 

[36] Rawal S K, Singh A, Khanna A. Robot-assisted video endoscopic inguinal lymph node dissection for carcinoma penis[J]. Journal of Endourology, 2022, 36(S2): S12-S17. 

[37] JI A L, LYU J, BAI Y C, et al. Single-position robotic assisted laparoscopic anterograde bilateral inguinal lymphadenectomy versus laparoscopic inguinal lymphadenectomy for penile cancer: a retrospective controlled study[J]. Asian Journal of Surgery, 2022, 45(8): 1530-1534. 

[38] Sávio L F, Barboza M P, Alameddine M, et al. Combined partial penectomy with bilateral robotic inguinal lymphadenectomy using near-infrared fluorescence guidance[J]. Urology, 2018.DOI: 10.1016/ j.urology.2017.11.021. 

[39] Patel A S, Isharwal S. Single-port robotic inguinal lymph node dissection: a safe and feasible option for penile cancer[J]. Surgical Oncology, 2021. DOI: 10.106/ J.SURONC.2021.101633. 

[40] Abdullatif V A, Davis J, Cavayero C, et al. Singleport robotic inguinal lymph node dissection for penile cancer[J]. Urology, 2022. DOI: 10.1016/ J.UROLOGY.2021.12.007. 

[41] 郁华亮 , 卢永良 , 肖毅 , 等 . 机器人辅助腹腔镜顺 行腹股沟淋巴结清扫术的临床研究 [J]. 中华泌尿外 科杂志 , 2018, 39(1): 38-41. 

[42] YU H L, LU Y L, XIAO Y, et al. Robot-assisted laparoscopic antegrade versus open inguinal lymphadenectomy: a retrospective controlled study[J]. BMC Urology, 2019, 19(1): 135-141.