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Pelvic Lymph Node Dissection

The lymphatic system fights infections and is made up of lymph vessels, lymph fluid, lymph nodes, bone marrow and the lymphatic organs. The lymph nodes in the pelvis lie along the main blood vessels that supply blood to the lower abdomen and trunk of the body.
A pelvic lymph node dissection (PLND) is a surgery to remove the lymph nodes from the pelvis. It is also called a pelvic lymphadenectomy, ilioinguinal lymphadenectomy or deep groin dissection.

Who needs PLND?

PLND is indicated in early stage cervical cancer, uterine cancer, all bladder cancer patients requiring a cystectomy, and for prostate cancer patients requiring a prostatectomy.

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What to expect before surgery?

Prediction of lymph node status can help in preoperative staging for pelvic lymph node dissection. CT scanning is most commonly performed for this purpose.

What happens during PLND?

A PLND is done under general anesthesia. It may be done using a wide cut (open method) or laparoscopy.
Dr. Naresh will make a cut in the abdomen and remove the pelvic lymph nodes. The lymph nodes and any other tissue removed during surgery are sent to a lab to be examined by a pathologist.
After removing the lymph nodes, the surgeon places a drain and closes the cut with stitches or staples. A drainage bag is attached to the end of the tube to collect fluid draining from the area. This reduces the chance of fluid building up in the tissue and improves healing. The drain is left in place for a few weeks or until there are little or no drainage.

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What to expect post PLND?

Post PLND surgery, the patient is usually sent home after 3-7 days. Doctor will prescribe antibiotics to prevent infection, explain about wound care, inform about how to manage the drain and what symptoms or side effects patient might experience like discomfort in abdomen, foul-smelling discharge or lymphedema. Dr. Naresh will advise the patient about types of activities that patient can do after surgery and provide you a follow-up appointment after 1-2 weeks.