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Surgeon-Performing-Inguinal-Lymph-Node-Dissection

Lymph node dissection can be a significant part of a cancer treatment plan.

Clusters of lymph nodes scattered throughout the body connect to each other through a network of vessels. These vessels transport various fluids, nutrients and cells into the bloodstream.

  • These vessels also collect toxins, germs and other impurities and carry them back to the lymph nodes for filtering.
  • Cancer cells will also sometimes travel through this lymphatic network.

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How it Works

Lymph node dissection is a surgical procedure to remove the cluster of lymph nodes most at risk for carrying cancerous cells to other parts of the body. The kidney, bladder or male and female reproductive organs are typical places urogenital cancers are found. Therefore, surgery usually targets the lymph nodes most closely associated with these organs. This includes the inguinal and retroperitoneal areas.

Lymph node dissection is only one part of an overall cancer treatment plan and the timing of surgical intervention will vary with staging and treatment. For those with early-stage disease, surgery may help them avoid chemotherapy.

Surgeon-Performing-Retroperitoneal-Lymph-Node-Dissection
Surgeon-Performing-Lymph-Node-Dissection

Inguinal Lymph Node Dissection

This surgery removes the lymph nodes in the groin area. There are both superficial and deep node clusters. Not all patients will have the deep nodes removed. This procedure, known as a deep inguinal lymphadenectomy, is usually done when cancer has spread throughout other nodes.

Sometimes, removal of these lymph nodes can cause issues with fertility in men. There is a modified surgical approach designed to protect the nerves and help prevent this. Inguinal lymph nodes can be removed with an excisional method or robotic-assisted laparoscopic surgery.

Retroperitoneal Lymph Node Dissection

Some cancers have a pattern of spreading that is very predictable. In particular, testicular cancer is known to travel to a region of the body called the retroperitoneum. This area is toward the back, between the kidneys and abdomen.

Removal of these lymph nodes can cause issues with erections and fertility in some men. There is a modified surgical approach designed to protect the nerves and help prevent this. Using robotic-assisted techniques, the recovery tends to be easier and hospital stays are shorter.

Lymphedema as a Possible Complication

While there is no question that lymph node dissection is often beneficial for cancer patients, it is not without side effects. The most notable complication is lymphedema, which is an accumulation of lymph fluid.

Once the lymph nodes are gone, the pathways that drain fluid can become damaged. Lymph fluid will pool in the surrounding tissues, causing the area to distend and feel heavy. The legs and scrotum tend to be the most affected.

Not every person that has lymph node dissection will develop lymphedema. There's no definitive way to determine who will be affected. Additional therapies, such as radiation, can aggravate the condition. However, there are many treatments designed to help with this complication.

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faculty_ahlering
Thomas E. Ahlering, M.D.
Urological Cancers
Professor and Vice Chairman
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Cory M. Hugen, M.D.
Urological Cancers
Assistant Clinical Professor of Urology
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Edward Uchio, M.D., F.A.C.S., C.P.I.
Urological Cancers
Associate Professor of Clinical Urology
faculty_jordan
Mark Jordan, M.D., F.A.C.S., F.R.C.S. (C)
Urological Cancers
HS Clinical Professor

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