The role of robotic-assisted inguinal lymphadenectomy in vulval cancer: feasibility, peri-operative outcomes and oncological safety.

Vulval cancer is a rare tumor, accounting for 3-5% of malignancies of the female reproductive system. The surgical management usually involves the radical excision of the tumor and inguinal node assessment for tumors with depth >1mm. Inguinal node dissection is usually performed as an open procedure through a 5-10cm incision in the groin area and carries a high risk of postoperative complications including wound infection, delayed wound healing, lymphocele and lymphedema which may result in prolonged hospitalization and delay in the adjuvant treatments for these patients. The role of minimal invasive surgery (MIS) in inguinal node dissection has been recently explored. Data extrapolated from melanoma and penile cancer patients showed that MIS inguinal node dissection is feasible, but it requires technical expertise and involves a steep learning curve. The aim of our study is to explore the feasibility and the oncological safety of the robotic inguinal node dissection for patients with vulval cancer, with secondary endpoint the intra- and post-operative outcomes for these patients compared to the open approach.