Robotic Retroperitoneal Lymph Node Dissection (RPLND)

Retroperitoneal Lymph Node Dissection is recommended to:

• Remove cancerous lymph nodes and reduce the risk of cancer spreading
• Provide accurate staging of the cancer
• Treat residual lymph node masses after chemotherapy

It plays a crucial role in both diagnosis and treatment of testicular cancer and may lead to a cure without additional therapy in some cases.

You will be contacted 1–2 weeks prior to your scheduled procedure with specific fasting instructions and hospital admission details. You will also receive a link to complete your online admission forms.

It is important to advise the rooms if you are taking any blood thinners or any prescribed medications for diabetes or weight loss purposes. The rooms can be contacted on   9329 1197

The procedure is performed under general anaesthesia or a spinal anaesthesia. It consists of the following steps:

• Several small incisions are made in the abdomen.
• A robotic system is used to insert a camera and instruments through these incisions.
• Prof Lawrentschuk controls the robotic arms from a console, providing enhanced dexterity and a 3D magnified view.
• Lymph nodes in the retroperitoneum are carefully dissected, removed and sent for pathology testing.

The procedure may take longer than open RPLND (completion of procedure without robotic instruments) due to setup and precision steps, but usually results in shorter hospital stays and less post-operative pain.

You will be admitted on the day of your surgery, with a typical hospital stay lasting 3-5 nights. Post- operatively, patients may spend the first night or longer in the Intensive Care Unit (ICU). Please note that:

• Normal eating is usually delayed for several days due to bowel inactivity (ileus), which can take up to a week to resolve.
• Pain at the incision sites is common but is usually well-managed with medication.

Once at home, please note the following:

• Driving should be avoided for 2-3 weeks or once you are comfortable enough without the requirement of strong pain medication.
• Returning to work is not recommended for at least 2 weeks
• Vigorous exercise or heavy lifting should be avoided for 6–8 weeks
• You can usually return to light activities within 2–3 weeks

Alternative treatment options include:

• Surveillance: Careful monitoring with imaging and blood tests for certain early-stage cancers
• Chemotherapy: Often used for advanced disease or when lymph nodes are extensively involved
• Open RPLND: A traditional surgical method with larger incisions

Prof Lawrentschuk will discuss the most suitable course of action for you.

• Signs of infection, including fever.
• Long-lasting nausea and vomiting.
• Excessive pain that you can’t control with your prescribed medications.
• Inability to pass gas or have a bowel movement.

A follow-up appointment will be scheduled 6-8 weeks post-surgery to:

• Review your recovery
• Discuss histopathology results of the removed tissue

Pathology results are typically available within 10–14 days. In some cases, your results may be reviewed in a multidisciplinary team meeting to determine the most effective next steps. If this occurs, you will be notified and kept informed of the team’s recommendations.