Radical Orchiectomy(click here for FAQs about Radical Orchiectomy)
- This involves removal of the testes, the surrounding capsule, and the spermatic cord – the structure that connects the testes to the abdomen.
- These are performed through an incision in the lower part of the abdomen: the scrotum is left untouched. This is to prevent spread of testes cancer cells. A prosthetic testes can be placed at the time of surgery.
- After surgery, the patient is advised to be sedentary for several days and is given and ice pack and athletic supporter to help prevent untoward bleeding..
- If appropriate, sperm banking before orchiectomy should be considered.
RPLND [Retroperitoneal Lymph Node Dissection](click here for FAQs about RPLND)
- This involves removal of the lymph tissue from the retroperitoneum, the part of the abdomen behind the intestines. All, or part of the lymph tissue (either a standard or a modified template RPLND) may be removed. This operation involves surgery close to the kidneys, the ureters, the intestines, large blood vessels, and nerves that assist with reproduction.
- The RPLND can be performed laparoscopically (through a small incision) or open (through a large incision). The large incision may be in the middle of the abdomen or maybe up near the lungs. The actual location and approach will be a topic of discussion for you and your physician.
- RPLNDs performed after chemotherapy are much more complicated and the rate of side effects (such as lymphocele, injury to surrounding structures, bleeding) are higher. Post-chemo-RPLNDs are not performed laparoscopically.
- Doctors at the University of Chicago perform nerve-sparing RPLNDs, so that normal reproduction can occur after treatment is complete.