Videosurgery
Single-port robotic inguinal lymph node dissection:optimizing perioperative outcomes with a novelregionalized surgical approach
Nicolas A. Soputro, Julie Klock, Carter D. Mikesell, Lin Wang, Jihad Kaouk, Nima Almassi
Glickman Department of Urology, Cleveland Clinic, Cleveland, Ohio, United States of America
Citation: Soputro NS, Klock J, Mikesell CD, et al. Single-port robotic inguinal lymph node dissection: optimizing perioperative outcomes with a novel regionalizedsurgical approach. Cent European J Urol 2026; 79: 472.
Key Words: single-port • robotic surgery • inguinal lymph node dissection • penile cancer

Inguinal lymph node dissection (ILND) has oftenbeen considered among patients with ≥pT1b penilesquamous cell carcinoma (SCC). In this video,we describe the surgical technique of a roboticILND using the purpose-built single port (SP) roboticplatform on a 78-year-old man who previouslyunderwent total penectomy for a moderately differentiatedpenile SCC with corpus spongiosum invasionand negative surgical margins (pT2NxR0).Despite a negative staging scan for metastatic disease,physical examination demonstrated mobile,subcentimeter inguinal lymph nodes bilaterally.The patient elected to undergo SP-ILND, whichwas completed through a single 3 cm incision at twofingerbreadths beneath the inguinal crease withinthe femoral triangle. The procedure was completedsuccessfully without the need for an additionalport or evidence of intraoperative complications.The robotic console time was 146 minutes, and intraoperativeblood loss remained minimal at 10 ml.The patient was ready for discharge home within4 hours. He reported minimal postoperative painand lower extremity edema. Histopathology revealed 6 lymph nodes from the right and five fromthe left, with evidence of metastatic SCC with extranodalextensions involving the left medial packets(pN3). There was no report of postoperativecomplications within 90-days of surgery. Despitethe need for future studies, this novel minimallyinvasive surgical technique promises significant enhancementsin patient recovery, favoring reducedpostoperative pain, less risk of lower extremity edema,and shorter hospital length of stay.

Article history
Submitted: 16 April, 2026
Accepted: 9 May, 2026
Published online: 19 June, 2026
doi: 10.5173/ceju.2026.0153
Corresponding author
Nima Almassi
email: almassn2@ccf.org
Conflicts of interest:  The authors declare no conflicts of interest.
This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0). License (http://creativecommons.org/licenses/by-nc-sa/4.0/).
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