Retroperitoneal Lymph Node Dissection (RPLND)
Retroperitoneal lymph node dissection (RPLND) is surgery to remove lymph nodes from the abdomen. The procedure is a type of lymphadenectomy.
Lymph nodes are small structures in the body that help filter waste and fight disease, playing a key role in the immune system. RPLND removes lymph nodes located in the retroperitoneal section of the body, which is the space behind the organs in the abdomen.
The procedure can also be used to determine the stage of cancer. The stage will show how severe the cancer is and how far it has spread throughout the body. Once the lymph nodes have been removed, they will be sent to a lab to identify the cancer stage.
The Goal of RPLND
Lymph nodes are removed during a RPLND to prevent cancer from spreading. This procedure can be used to treat testicular cancer, an abnormal growth that develops in one of the testicles, which are the glands that hang below the penis. The testicles produce hormones (testosterone) and sperm.
Testicular cancer typically starts in one testicle. Patients with mild cases of testicular cancer may be treated with chemotherapy and other less invasive treatments. However, in more serious cases, testicular cancer can spread through the lymph nodes in the retroperitoneal space (or the abdominal cavity) into other parts of
the body. Surgically removing the lymph nodes can stop the cancer from spreading.
What to Expect During Surgery
During the procedure, the surgeon will make an incision in the abdomen to remove lymph nodes on the same side as the affected testicle. In other words, if the left testicle is cancerous, the lymph nodes on the left side of the abdomen will be removed.
The main goal of RPLND is to remove all traces of cancer so that it does not spread. In some cases, the surgeon may also need to remove other structures in the body:
- Lymph nodes on the other side of the body: If the cancer has spread to both sides of the body, the surgeon will remove lymph nodes on the other side of the retroperitoneal space.
- Blood supply: To treat testicular cancer with RPLND, the blood supply to the affected testicle and sperm cord may need to be removed.
The Recovery Process
Right after the procedure, the physician will place a drain in the abdomen to remove extra fluid and collect it in a bag outside of the body. The bag will be left in place for a few days. Patients will need to stay in the hospital for a few days because RPLND is a lengthy surgery that takes several hours.
RPLND is used to both stage testicular cancer and prevent it from spreading throughout the body by removing the lymph nodes.
Once the lymph nodes have been analyzed in a laboratory, the physician will use additional therapies, such as chemotherapy, to continue treating testicular cancer. The survival rate of patients diagnosed with testicular cancer is very high.
Potential Risks
The risks of RPLND include:
- Damage to the blood vessels
- Retrograde ejaculation
- Lymphocele
- Post-surgery complications
