Mr Thyer offers specialist management of prostate cancer.
Mr Thyer has a special interest in robotic and laparoscopic surgery for prostate and kidney cancer but also performs surgery for many other urological conditions.
Retro-Peritoneal Lymph Node Dissection (RPLND) is usually performed for testicular cancer. Mr Thyer has also performed RPLND for cancers originating elsewhere for example kidney, skin, pancreas, prostate and cervix.
The lymphatic system is a network of fine vessels throughout the body that transports lymph (tissue fluid) back to the heart. The lymph nodes are stationed along the lymphatic vessels where immune system cells congregate to fight infections and cancer. Testicular cancer will sometimes spread along lymphatic channels and grow within lymph nodes around the aorta and vena cava (large blood vessels in the back of the abdomen). Chemotherapy will usually remove any cancer in the lymph nodes but occasionally the lymph nodes remain enlarged raising the possibility that the cancer remains dormant within the lymph nodes. Your oncologist has referred you to Mr Thyer to have the retro-peritoneal lymph nodes removed.
Ten days prior to the procedure you should:
On arrival at hospital you will be prepared for theatre by nursing staff. Mr Thyer will see you just prior to being taken into the operating theatre. You will require a general anaesthetic of approximately 4 hours. Mr Thyer will make an incision from the breast bone to the pubic bone. The abdominal contents will be shifted aside and the aorta and vena cava exposed. The lymph nodes around these structures will be removed and sent to a pathologist for microscopic examination (you may incur a pathologist fee). The lymphatic channels that have been disrupted will be clipped to avoid lymphatic leak. The abdominal contents will be replaced in their normal position. After the operation a drain will be left in the abdomen and a catheter in the bladder. Most men spend one night in ICU then are shifted to the ward for a further 2 nights before being discharged home after Mr Thyer’s review.
Note: A vascular surgeon will be on standby to assist Mr Thyer if the lymph nodes are adherent to the aorta or vena cava
Mr Thyer’s rooms will contact you to arrange follow up to check your progress, wounds and pathology 3 weeks following the operation. You should consume a very low fat diet, take laxatives, wear compression stockings, drink plenty of water and avoid heavy lifting for 3 weeks following the procedure. You should not drive a motor vehicle until seen by Mr Thyer at the follow up appointment. Your oncologist will follow you up beyond this appointment.
Following the procedure, you should contact Mr Thyer if you: