Retroperitoneal Lymph Node Dissection (RPLND) ERAS

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.