Cancer Testis & Rplnd

Retroperitoneal Lymph Node Dissection (Rplnd)

Retroperitoneal Lymph node dissection (RPLND) can be performed by open or laparoscopic approach. Laparoscopic RPLND has several advantages over conventional open surgery with same cure rate. Only surgery is curative in most of the cancers. Additional therapies (chemotherapy & radiotherapy) are mostly supportive. But, many patients and their relatives try to avoid surgery for the fear of the immense trauma for their loved ones, resulting in patient getting wrong or less effective treatment. With laparoscopy the trauma is much less and makes the treatment more acceptable. The Team MACS precisely addresses all these issues and works relentlessly for a better life

open surgery vs laparoscopic surgery
Dr. Sandeep Nayak

DR. SANDEEP NAYAK

MBBS, MRCSEd, DNB (Gen Surg),
MNAMS (Gen Surg), DNB (Surgical Oncology),

Fellowship in Laparoscopic and Robotic Onco-Surgery.
Dr Nayak is one of the leading senior Surgical Oncologists (cancer surgeon) of Bangalore. He is one of the pioneers of Laproscopic (laparoscopic) cancer treatment (surgery). He is the Director of Surgical Oncology at Fortis Hospital, Bangalore.

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The Advantages Of Robotic & Laparoscopic Cancer Surgery Include

Cancer Of Testis

Testicular cancer is a condition where the cells in the one or both of the testis become cancerous. Testis is the organ where sperms are produced. Testis also produces male hormone called testosterone.

Most of the patients notice a lump in their testis which is usually painless. When the lump becomes very large, there may be dragging sensation.

Diagnosis is confirmed most of the times using ultrasound examination. A CT scan is essential for staging the condition. In addition blood tests are done to measure the level of tumor markers in blood. These help in planning the treatment.

Surgical removal of the affected testis is the first step in the treatment. This confirms the diagnosis, type of cancer, stage as well as serves as the treatment in these cases. There are many types of testicular cancers. However, they are broadly grouped under seminoma and non-seminomas. Depending on the type of cancer and the stage some patients may require retroperitoneal lymph node dissection.

Staging Of Cancer Of Testis

Testicular cancer (seminoma and non-seminomas) has three stages.

  • Stage I means that the cancer is confined to the testicle.
  • Stage II means that it has spread to the lymph nodes in the abdomen.
  • Stage III means that cancerous cells spread beyond the abdominal lymph nodes to other parts of the body

When Is Retro-Peritoneal Lymph Node Dissection Needed?

  • Stage I non-seminoma cancer. Where RPLND would confirm the staging as well as cure (if nodes turnout to be positive). Alternative would a chemotherapy or just surveillance.
  • Stage II nonseminoma cancer. RPLND confirms whether the nodes are truly affected. If only a small amount of cancer is found, the surgery alone might cure it. If the cancer in lymph nodes is large enough RPLND may reduce the amount of chemotherapy required to cure the cancer.
  • RPLND after chemotherapy. This is performed only if there is some tissue (more than 1-2cm) left behind after chemotherapy. These tissues can grow are cause problem in the future.

What Is Retro-Peritoneal Lymph Node Disection (Rplnd)

Retroperitoneal lymph nodes are lymph nodes (small nodular structures that are present throughout the body that clear the tissue fluids) that are found in the back of belly or abdomen. These are involved in clearing fluid from the lower half of the body. Testis in men and ovaries among women drain into these nodes. So, the cancers of these organs can spread to these lymph nodes. This region also contains aorta and inferior vena cava which are the main blood vessels of the body. In addition there are many important nerves passing through this region.

Conventional open surgery involves long incision over the abdomen starting from above the belly button reaching all the down. This is required are the tissues in the back of the abdomen have to be reached.

Laparoscopic or retroperitoneoscopic RPLND. This involves a few tiny cuts through which camera and instruments are passed to dissect the lymph nodes and remove them. With the enhanced vision quality, the nerves can be better preserved resulting in better outcomes for the patient.

Retroperitoneal lymph nodes are lymph nodes (small nodular structures that are present throughout the body that clear the tissue fluids) that are found in the back of belly or abdomen. These are involved in clearing fluid from the lower half of the body. Testis in men and ovaries among women drain into these nodes. So, the cancers of these organs can spread to these lymph nodes. This region also contains aorta and inferior vena cava which are the main blood vessels of the body. In addition there are many important nerves passing through this region.

Conventional open surgery involves long incision over the abdomen starting from above the belly button reaching all the down. This is required are the tissues in the back of the abdomen have to be reached.

Laparoscopic or retroperitoneoscopic RPLND. This involves a few tiny cuts through which camera and instruments are passed to dissect the lymph nodes and remove them. With the enhanced vision quality, the nerves can be better preserved resulting in better outcomes for the patient.