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Subinguinal Incision: Steps of the Surgical Approach

Urologic Indications

Inguinal lymphadenectomy in patients with:

• Penile cancer
• Cancer of the distal urethra

Patient Positioning:

Supine position with slight abduction of the hip and flexion of the knee.

Surgical Technique of an Subinguinal Incision

• Skin incision 3 cm below and parallel to the inguinal ligament, see fig. groin surgery
• Straight dissection of the subcutaneous tissue through the fascia of scarpa to the fascia lata. The skin should be dissected together with the subcutaneous tissue to preserve the supplying vessels.
• Identification and isolation of the great saphenous vein and superficial veins near the fossa ovalis (superficial epigastric, superficial iliac circumflex, and superficial external pudendal veins).

Wound Closure:

Redon drains, subcutaneous closure with interrupted sutures. Depending on the extend of dissection, myocutaneous flaps are necessary to cover the femoral vessels and to promote wound healing.

Groin incision to approach the inguinal lymph nodes: skin incision 3 cm below and parallel to the inguinal ligament

References

J. A. Smith, S. S. Howards, G. M. Preminger, and R. R. Dmochowski, Hinman’s Atlas of Urologic Surgery Revised Reprint. Elsevier, 2019.

  Deutsche Version: Operativer Zugang zu den inguinalen Lymphknoten

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