Retroperitoneal Lymph Node Dissection (RPLND) ERAS

Retroperitoneal lymph node dissection (RPLND) is surgery that removes lymph nodes from deep in your abdomen. This procedure is most often used to prevent the spread of testicular cancer.

Our RPLND ERAS program is designed to help patients return to health more quickly after undergoing the surgery.

Prior to Surgery

• Your surgeon will meet with you to explain surgical plans and set your expectations for surgery.
  • Contact your surgeon via MyChart or call the surgical clinic with questions: 214-645-8765.
• We will call you to provide instructions for surgery and medications prior to surgery. You might also be scheduled for an appointment in our pre-surgical testing clinic to meet with our anesthesia team or have blood drawn.
  • We might request testing from your other physicians.
  • Call our pre-surgical testing clinic with any questions: 214-633-4202.
• Lifestyle modifications:
  • We encourage you to stop smoking and consuming alcohol for one month prior to surgery.
  • We encourage you to increase your physical activity prior to surgery.
  • Eat a balanced, healthy diet high in fat, and remain hydrated.
• On the night before surgery, do not eat solid foods after 11 p.m.
• Follow instructions from your surgeon regarding skin and bowel preparation.
• You can drink clear liquids (such as water, Gatorade, or Sprite) up to two hours before your surgery start time.
• Drink a 20-oz. Gatorade on the way to the hospital, at least two hours before your surgery start time.
• In the pre-op area, you will receive oral non-narcotic pain medications (celecoxib, acetaminophen, and pregabalin) to improve your postoperative pain.

During Surgery

• You will receive general anesthesia and be completely asleep during the procedure.
• Your anesthesia team will monitor you very closely while you are asleep and will insert additional intravenous (IV) lines or monitors if necessary.
• You will receive multiple medications during surgery to treat pain and nausea.
• There will be a specific and tailored anesthetic protocol to decrease the stress on your body, improve pain control, and accelerate your recovery.
• A nerve block might be performed prior to or during the procedure. This is designed to decrease your postoperative pain and need for IV and oral pain medications.

Post-Anesthesia Care Unit (PACU) and After

• You will wake up in our post-anesthesia care unit (PACU).
• You will be asked to chew gum and ice chips and to drink clear liquids to help with recovery of bowel function.
• You will be given an incentive spirometer to remind you to take deep breaths.
• Starting on the day of your surgery, we encourage you to get out of bed and walk with help from your nurse.
  • Try to increase the distance and frequency of your walks each day; doing so will help your bowel function return to normal, prevent deconditioning, and speed up your recovery.
• Unless instructed otherwise by your nurse or surgeon, you will be able to eat a normal diet the day after your surgery. Continue to chew gum or hard candy as well.
• You will take scheduled non-opioid pain medications during your recovery and have narcotic medications available for breakthrough pain if necessary.