Robotic-Assisted Inguinal Lymphadenectomy (RAIL): A Novel Surgical Technique to Manage the Inguinal Region for Patients with Penile Cancer

Open inguinal lymphadenectomy (ILND) remains a standard surgical technique to manage the inguinal region for patients with suspected inguinal metastases. Although this procedure remains highly accurate and therapeutic, it is associated with high morbidity rates. Although patients with impalpable disease are suitable for less invasive procedures such as dynamic sentinel lymph node biopsy, false negative rates are low in experienced high volume centers but still remain a concern when the technique is used in smaller centers. This has led to the development of minimally invasive surgery to manage impalpable or small volume nodal disease in high risk patients with penile cancer. In this chapter we describe the technique and experience using robotic assisted inguinal lymph node dissection (RAIL).