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Robotic Post Chemotherapy Retroperitoneal Lymph Node dissection PC-RPLND for Testis Tumour

Overview

Post-chemotherapy retroperitoneal lymph node dissection (PC-RPLND) is a specialized surgical procedure performed for testicular cancer patients who have residual lymph node masses after completing chemotherapy. With the evolution of robotic surgery, PC-RPLND has become safer, more precise, and associated with quicker recovery.

Our urology and uro-oncology center provides state-of-the-art Robotic PC-RPLND, ensuring the highest level of surgical accuracy with minimal complications.

PC-RPLND (Post-Chemotherapy Retroperitoneal Lymph Node Dissection) is a surgery performed to remove remaining lymph node masses in the retroperitoneum (the area behind the abdomen where lymph nodes drain the testicles).

Even after chemotherapy, some patients retain:

  • Residual tumours
  • Fibrosis/scarring
  • Teratoma (chemotherapy-resistant cells)
  • Persistent lymphadenopathy
  • PC-RPLND ensures removal of this remaining disease to prevent recurrence.

Robotic surgery offers significant advantages in this complex procedure due to:

  • High magnification 3D vision
  • Tremor-free precision
  • Better access in deep retroperitoneal areas
  • Improved nerve-sparing capability

It is particularly beneficial in post-chemotherapy cases, where tissues may be fibrotic or stuck to vital structures.

Your urologist may recommend robotic PC-RPLND if you have:

  • Residual lymph node mass >1 cm after chemotherapy
  • Persistent tumour markers
  • Growing teratoma syndrome
  • Residual teratoma or viable tumour on imaging
  • Non-seminomatous germ cell tumour (NSGCT) where post-chemo nodes remain

It plays a crucial role in curative treatment for advanced testicular cancer.

PC-RPLND is usually based on imaging findings, but patients may experience:

  • Persistent back/abdominal pain
  • Palpable mass
  • Elevated tumour markers
  • CT/MRI showing residual nodes

     

Even if asymptomatic, residual masses need evaluation to avoid recurrence.

1. Pre-operative Assessment

  • CT scan/MRI
  • Tumour marker evaluation (AFP, β-hCG, LDH)
  • Review of chemotherapy response
  • Cardiac & anesthesia clearance

     

2. Surgical Technique

  • Performed through small keyhole incisions
  • Retroperitoneal area accessed using robotic instruments
  • Precise removal of lymph nodes from designated templates
  • Preservation of vital structures including:
    • Aorta & vena cava
    • Renal vessels
    • Sympathetic nerves (to maintain ejaculation)

       

3. Nerve-Sparing PC-RPLND

Whenever possible, nerve-sparing techniques are used to preserve:

  • Ejaculatory function
  • Fertility potential
  • Quality of life

     

4. Duration & Hospital Stay

  • Surgery duration: 3–6 hours (depending on complexity)
  • Hospital stay: 2–4 days
  • Early mobilization encouraged

Compared to traditional open surgery, robotic PC-RPLND offers:

  • Smaller incisions & minimal scarring
  • Lower blood loss
  • Reduced postoperative pain
  • Faster recovery
  • Improved visualization of complex anatomy
  • Higher nerve-sparing rates
  • Faster return to normal activities

While robotic PC-RPLND is safe in experienced hands, potential risks include:

  • Bleeding
  • Injury to surrounding organs/vessels
  • Chylous leak
  • Temporary digestive symptoms
  • Infection
  • Rare need to convert to open surgery
  • Complication risks are significantly reduced with meticulous robotic technique.

Most patients experience:

  • Mobilization within 24 hours
  • Return to work in 2–3 weeks
  • Resume physical activity in 4–6 weeks
  • Regular follow-up with tumour marker tests
  • Follow-up imaging as advised

Our team provides a personalised recovery plan tailored to each patient.

When performed at the appropriate stage and by an expert uro-oncologist:

  • High cure rates for NSGCT
  • Effective removal of chemotherapy-resistant teratoma
  • Low recurrence rates
  • Good preservation of fertility & sexual function

Robotic PC-RPLND offers an excellent balance between cure and quality of life.

If you or a loved one needs a kidney transplant, consult Dr. Amit Goel, a trusted Urologist & Kidney Transplant Specialist, to discuss robotic or open transplant options and donor procedures.

 

📍 C2/902, Parsvnath Exotica, DLF Phase 5, Sector 53, Gurugram, Haryana 122003  

 

📞 +91 84470 18167

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