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Armando E. Giuliano, MD
Santa Monica, Calif

Arch Surg. 1998;133:275.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

The authors should be commended for their diligence in refining the technique of a laparoscopically assisted ilioinguinal node dissection for patients with American Joint Commission on Cancer stages I or II melanoma. They have managed to excise a statistically similar number of lymph nodes using the laparoscopically assisted approach as with the open approach (approximately 10 nodes in each ilioinguinal node dissection). However, does the technical ability to perform this procedure justify its practice? Does this technique really benefit the patient? During the standard approach for an open deep ilioinguinal node dissection, described by Karakousis¹ and to which the authors refer, the inguinal ligament is transected. Laparoscopic IIL was developed to avoid this transection, thus decreasing pain and morbidity. However, in the text of his description of the standard operation, Karakousis also mentions an effective modification of his technique that preserves the inguinal ligament, by making . . . [Full Text of this Article]

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