Journal of Robotic Surgery

, Volume 13, Issue 2, pp 361–362 | Cite as

Robotic inguinal lymph node dissection for melanoma: a novel approach to a complicated problem

  • R. Elia
  • Erica Tedone ClementeEmail author
  • M. Vestita
  • E. Nacchiero
Letter to the Editor


Following the interesting reading of the article “Robotic inguinal lymph node dissection for melanoma: a novel approach to a complicated problem”, the authors review the pros and cons of a minimally invasive technique for lymph node dissection, the consequences of complete lymph node dissection and the possible treatments for lymphedema, such as lymph node flap transfer and multiple lymphatic-venous anastomoses. The authors also review the possible benefits of applying the robotic technique to anatomical sites other than the inguinal one.


Malignant melanoma Lymph node excision Lymphedema Robotic surgery 



All authors hereby declare not to have any potential conflict of interests and not to have received funding for this work. Each author participated sufficiently in the work to take public responsibility for the content and agree to its publication.

Compliance with ethical standards

Conflict of interest

None disclosed.


  1. 1.
    Hyde GA, Jung NL, Valle AA, Bhattacharya SD, Keel CE (2018) Robotic inguinal lymph node dissection for melanoma: a novel approach to a complicated problem. J Robot Surg 12(4):745–748CrossRefGoogle Scholar
  2. 2.
    Tonouchi H, Ohmori Y, Kobayashi M, Konishi N, Tanaka K, Mohri Y, Mizutani H, Kusunoki M (2004) Operative morbidity associated with groin dissections. Surg Today 34(5):413–418CrossRefGoogle Scholar
  3. 3.
    Bland KI, Klamer TW, Polk HC Jr, Knutson CO (1981) Isolated regional lymph node dissection: morbidity, mortality and economic considerations. Ann Surg 193(3):372–376CrossRefGoogle Scholar
  4. 4.
    Spillane AJ, Cheung BL, Stretch JR, Scolyer RA, Shannon KF, Quinn MJ, Saw RP, McCarthy WH, Thompson JF (2009) Proposed quality standards for regional lymph node dissections in patients with melanoma. Ann Surg 249(3):473–480CrossRefGoogle Scholar
  5. 5.
    Sandro P, Andrea M, Nicola M, Simone M, Giuseppe M, Lorenzo B, Nicola S, Dario P, Luigi M, Giuseppe G, Roberto P, Corrado C, Simone R, Ugo M, Mario S, Riccardo RC (2015) Lymph-node ratio in patients with cutaneous melanoma: a multi-institution prognostic study. Ann Surg Oncol 22(7):2127–2134CrossRefGoogle Scholar
  6. 6.
    Rossi CR, Mozzillo N, Maurichi A, Pasquali S, Macripò G, Borgognoni L, Solari N, Piazzalunga D, Mascheroni L, Giudice G, Mocellin S, Patuzzo R, Caracò C, Ribero S, Marone U, Santinami M (2014) Number of excised lymph nodes as a quality assurance measure for lymphadenectomy in melanoma. JAMA Surg 149(7):700–706CrossRefGoogle Scholar
  7. 7.
    Zhang SH, Sood AK, Sorosky JI, Anderson B, Buller RE (2000) Preservation of the saphenous vein during inguinal lymphadenectomy decreases morbidity in patients with carcinoma of the vulva. Cancer 89(7):1520–1525CrossRefGoogle Scholar
  8. 8.
    Giudice G, Leuzzi S, Robusto F, Ronghi V, Nacchiero E, Giardinelli G, Di Gioia G, Ragusa L, Pascone M (2014) Sentinel lymph node biopsy in head and neck melanoma. G Chir 35(5–6):149–155Google Scholar
  9. 9.
    Ciudad P, Yeo MS, Sapountzis S, Lim SY, Nicoli F, Maruccia M, Kiranantawat K, Chen HC (2014) Microsurgical debulking procedure after free lymph node flap transfer. Microsurgery 34(8):670–671CrossRefGoogle Scholar
  10. 10.
    Ciudad P, Manrique OJ, Date S, Agko M, Perez Coca JJ, Chang WL, Lo Torto F, Nicoli F, Maruccia M, López Mendoza J, Chen HC (2017) Double gastroepiploic vascularized lymph node transfers to middle and distal limb for the treatment of lymphedema. Microsurgery 37(7):771–779CrossRefGoogle Scholar
  11. 11.
    Ciudad P, Kiranantawat K, Sapountzis S, Yeo MS, Nicoli F, Maruccia M, Sirimahachaiyakul P, Chen HC (2015) Right gastroepiploic lymph node flap. Microsurgery 35(6):496–497CrossRefGoogle Scholar
  12. 12.
    Ciudad P, Date S, Lee MH, Lo Torto F, Nicoli F, Araki J, Chen HC (2016) Robotic harvest of a right gastroepiploic lymph node flap. Arch Plast Surg 43(2):210–212CrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Plastic and Reconstructive Surgery, Department of Emergency and Organ TransplantationUniversity of Bari Aldo MoroBariItaly
  2. 2.Department of Dermatology, Brigham and Women’s HospitalHarvard Medical SchoolBostonUSA

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