A tumour can spread from its original site via the lymphatic drainage system to regional lymph nodes. The aim of this operation is to remove the regional lymph nodes in your pelvis, along with the surrounding fatty and connective tissue, and any tumour which has developed in them.
Quite often the operation is performed at the same time as a groin dissection, though it may be performed separately at a later date, particularly if your doctor detects cancer spread in the pelvis during follow-up.
The operation is performed under general anaesthetic which means you will be fully asleep during the entire operation. The anaesthetist will see you before your operation so you can discuss any queries about the anaesthetic you may have.
If you have had any difficulties during a general anaesthetic in the past, make sure both the anaesthetist and the ward doctor are aware of them.
After Your Operation
On the evening after your general anaesthetic you will feel rather tired and sleepy and should warn your visitors that you may not be very good company!
When you come back from the operating theatre you will have a small needle in your arm or hand attached to a drip. This will stay in until you are eating and drinking normally. Quite often, the bowel stops working for two or three days after the operation and it will not be possible to feed you during this time. The first sign of the bowel working again is the passign of wind, gas or flatus out the back-passage. It is important for the medical team to know this so please don’t be shy!
You will have a urinary catheter to allow the bladder to be drained without you having to get up to go to the toilet. This will be in for at least 2 days.
You will also have drains in your wound to drain any fluid from the wound. These stay in until they stop draining. Sometimes these drains need to be left in for a long period of time but usually the draining will eventually stop.
You will have a scar across the lower half of your abdomen (tummy) and extending for a short way on the side of the cancer.
It is common to have swelling in your leg called lymphoedema after a pelvic dissection, particularly if the operation has been done at the same time as a groin dissection. This is due to the disruption of the lymph vessels which carry lymph fluid from the leg across the groin and pelvis. It may improve with time but is unlikely to completely settle and can be troublesome.
It is important to take precautions to reduce the symptoms of lymphoedema and the occurrence of complications. Raise your leg whenever you are sitting to reduce swelling. If this is not enough to control the swelling you may need to wear a firm stocking during the day and especially when you are on your feet for prolonged periods.
Any infections of the leg or foot must be treated promptly as severe infections can develop rapidly in a leg with lymphoedema. Sometimes it is necessary to learn to massage the fluid out of your leg and if lymphoedema is a problem for you, you can ask to be referred to our specialist team who can teach you this technique.
Any operation can give problems with infection or bleeding. Simple infections will settle with skin treatment others through a course of antibiotics but some infections go on to form an abscess which may need a further operation.
If you notice increasing redness of your wound or it is painful, tell a doctor as soon as possible as infections caught early are easier to treat.
Bleeding after your operation may result in a collection of blood in the wound called a haematoma. If this happens you will need an operation to drain the haematoma or it may cause problems with the wound later on.
Once your drains have been removed and you are up and about and feeling well you will be able to go home. This is usually within a week. You may be sent home with your drains in and the nursing team will inform you about what to do with them.
Before you leave the ward you will be given an appointment for the dressing clinic. Any stitches you have will be removed at this appointment and your wound will be checked and your dressing changed. You will also be given an outpatient clinic appointment.
To start with you will feel rather tired and you should spend the first ‘eek or so taking it easy. After that you will be able to build slowly up to doing your usual activities.
You will be able to start driving once you feel up to it and you are able to perform an emergency stop comfortably. For most people this will take about 4 weeks. Do not drive if you are not well, alert and able to take emergency action. It is advisable to check with your insurance company before you start driving again.
You will be able to start work again once you feel up to it but if your job involves a lot of lifting or heavy work this will take longer. Speak to your GP who will give you a sick certificate to cover until you are fit to go back to work.