A laparoscopic pelvic lymph node dissection helps treat cancer. The surgeon makes a small incision in the lower abdomen to reach the lymph nodes. The surgeon inserts a tiny tube with a light and a camera (i.e., a laparoscope) into the incision and directs it to the lymph nodes.
The lymph nodes are part of the lymphatic system. The lymphatic system helps fight infections. It is made up of lymph vessels, lymph fluid, lymph nodes, bone marrow, and lymphatic organs (thymus, adenoid, tonsil, and spleen).
Lymph vessels are very thin tubes similar to blood vessels. They collect and move lymph fluid away from tissues into the lymph nodes. Lymph nodes are small bean-shaped organs of lymphatic tissue. The lymph fluid can carry cancer cells from where cancer started into the lymph nodes.
Lymph fluid from organs in the pelvis drains into the pelvic lymph nodes. The lymph fluid can carry cancer cells from these sites into the pelvic lymph nodes. Bladder and prostate cancers most commonly spread to the lymph nodes in the pelvis. Cancer may also spread to the pelvic lymph nodes from the following organs and tissues:
During a laparoscopic lymphadenectomy, the surgeon makes a small incision in the lower abdomen to reach the lymph nodes. A tiny tube with a light and a camera (i.e., a laparoscope) is inserted into the incision and directed to the lymph nodes.
The doctor navigates and inspects the region on a TV-like monitor that receives images from the camera and can biopsy or remove the lymph nodes with a cutting instrument and tissue retrieval apparatus that is also part of the laparoscope.
Laparoscopic lymphadenectomy can provide results equivalent to surgical biopsies or lymph node removal. Although it is carried out under general anesthesia, it is less invasive than surgery. So, your hospital stay will be shorter and you will recover much faster and with less pain.
In addition, the laparoscope images are magnified when they appear on the monitor, allowing your doctor to see even greater tissue detail than would be available during traditional surgery.
A pelvic lymph node dissection is done to:
Your surgeon does the operation through small cuts (keyholes) in your abdomen. They will use tools that have a tiny camera attached so that they can see the inside of your body on a screen.
In some hospitals, a robot will assist the surgeon. The surgeon is in the same room but sits away from you and controls the robotic arms to perform the surgery. It allows the surgeon to make more controlled and precise movements. The surgeon is still the one doing the surgery. This is sometimes called robotic surgery.
Recovery after keyhole surgery is usually faster because there is less blood loss. This means your hospital stay may be shorter.
People who have a PLND are usually sent home 3–7 days after surgery. You may be given:
The pathologist’s report includes the type of cancer, the number of lymph nodes removed, and the number of lymph nodes that have cancer cells. The report may also say if cancer has grown beyond the wall of the lymph node (extranodal or extracapsular extension).
Doctors use the number of positive lymph nodes to help stage cancer. They use the stage along with other information about the type and grade of cancer to make treatment decisions and give a prognosis .
Lymph node removal can cause side effects. These may only last for a short time after treatment but might last for weeks, months, or years after treatment has finished. It is important to remember that not everyone gets all possible side effects and there are ways to manage any side effects you do get.
It is important to consult your doctor if you experience any discomfort, pain or any of the following complications post the lymph node dissection:
Your surgery will usually take between 2 to 4 hours, depending on your surgery type.
Any surgery involves some potential risks.