Lymph Node Dissection

The lymphatic system is a network of channels distributed throughout the body. These are similar to blood vessels, but carry lymph (a liquid consisting of white blood cells and serum) from tissues back into the major blood vessels. Along the way, lymph nodes interrupt these channels and act like filters. These filters may swell when an infection is nearby as they remove infected material from the lymph. When a cancer is nearby, the lymph may carry cancer cells.

A lymph node that is palpable is almost always surgically removed. It is then sent to the pathology laboratory to be tested microscopically for the presence of malignant cells. If any are found, the rest of the nodes in that basin will also be removed, and treatments that stimulate the immune system and/or chemotherapy will be recommended.

If there is a good chance the prostate cancer has already spread to the lymph nodes, then it makes sense to check those lymph nodes before having major surgery. A laparoscopic lymph node dissection is a minimally invasive procedure to remove lymph nodes. The surgeon makes a number of tiny incisions just below the navel and, to increase the workspace, pumps air into the abdomen. A laparoscope, a slim tube with a tiny camera on the end, is inserted into one incision and, while watching the procedure on a TV monitor, the surgeon inserts instruments through the other incisions and removes the lymph nodes.

Though for some this procedure might seem worth it to set the mind more at ease, it can have quality-of-life implications. Anyone who has had this surgery is suggested with various kinds of after-care tips and instructions. Because lymph nodes are involved in fluid balance in the body and the immune system, there is some risk for the patients that they will develop swelling in their affected area at times (called lymphedema), and/or infections from wounds.

The level of risk for these complications is poorly understood. The problem is, there have been very few studies to determine what patients should do to lower their risk for lymphedema and infections. If you have had lymph dissection, very recent studies suggest strongly that some of the instructions given to you by your doctor have the potential to decrease risk for lymphedema. So, kindly follow the doctors reccomendations.

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