Inguinal lymph node dissection (ILND) is essential for staging and treatment in penile carcinoma patients. Video-endoscopic inguinal lymphadenectomy (VEIL) was developed to minimize complications, for patients requiring bilateral ILND. This study aims to assess the feasibility, safety, and preliminary oncological outcomes bilateral VEIL.

Retrospective single center analysis. All of them underwent a standard VEIL, all procedures followed the standardized technique. Inclusion criteria included penile cancer patients with no palpable lymph nodes and intermediate/high-risk disease.

The mean age was approximately 46.3 years (35-62 years) and mean lymph node yield of about 9.11 lymph nodes. 66.7% of the cases involved partial penectomy, while 33.3% required total penectomy. The tumor characteristics varied, with 55.6% having T2 stage and 44.4% having T3 stage, while all had adequate margins. Histopathological analysis revealed 44.4% patients with well differentiated SCC and 55.6% patients with moderately- differentiated SCC. There was no HPV involvement. There was also no perineural invasion, while only 11.1% that is one of the patients had lympho-vascular invasion. Lymph node assessment indicates that no patients showed signs of metastasis, with 100% reported as negative in both right and left lymph nodes. No further treatment was indicated for any of the patients. All of the patient's are alive with no significant morbidity

VEIL appears to provide effective long-term oncological control with reduced morbidity. In the absence of non-invasive stratification techniques like dynamic sentinel node biopsy, VEIL has become a viable option for managing non palpable lymph nodes with higher than T1 disease in penile cancer intermediate/high-risk disease.