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laproscopic groin dissection?
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laproscopic groin dissection?

› Forums › General Melanoma Community › laproscopic groin dissection?

  • Post
    • February 15, 2017 at 3:37 pm
    JustJaren
    Participant

      Anyone had this? What was recovery like? Time frame? Any complications?

       

      Thanks in advance!

    Viewing 4 reply threads
    • Replies
        • February 15, 2017 at 6:59 pm
        debwray
        Participant

          Hi,

          Try googling the term and look for the UK NICE guidance. Longer on op table, faster recovery.. Best in very experienced hands as more technical. Had the pelvic bit of my dissection done laproscopically followed by open groin dissection. There are pros and cons.Would try to find out how many of these your surgeon has done.It is harder to get all of the nodes laproscopically….

          Will post a link when have access to laptop.

          Brest of luck,

          Deb

          • February 15, 2017 at 6:59 pm
          debwray
          Participant

            Hi,

            Try googling the term and look for the UK NICE guidance. Longer on op table, faster recovery.. Best in very experienced hands as more technical. Had the pelvic bit of my dissection done laproscopically followed by open groin dissection. There are pros and cons.Would try to find out how many of these your surgeon has done.It is harder to get all of the nodes laproscopically….

            Will post a link when have access to laptop.

            Brest of luck,

            Deb

            • February 15, 2017 at 6:59 pm
            debwray
            Participant

              Hi,

              Try googling the term and look for the UK NICE guidance. Longer on op table, faster recovery.. Best in very experienced hands as more technical. Had the pelvic bit of my dissection done laproscopically followed by open groin dissection. There are pros and cons.Would try to find out how many of these your surgeon has done.It is harder to get all of the nodes laproscopically….

              Will post a link when have access to laptop.

              Brest of luck,

              Deb

              • February 16, 2017 at 12:41 pm
              debwray
              Participant

                Link as promised,   https://www.nice.org.uk/guidance/ipg398/evidence/overview-495911773

                More info if you plough through the references. Groin dissection is difficult as they remove the fat pad where they expect the nodes to be.. but some may fall outside the expected pattern,

                Think you have had the partial knee replacement but depending on how long ago this was swelling should have settled. The bigger issue seems to be with more horizontal scars that disrupt the lymph flow.   I know you are hovering on the pos and cons of this procedure. Would say if the positive node was enlarged and full of melanoma- prob best to go for it – but it is much more finely balanced where the traces are microscopic, and the medical community are also divided whist awaiting the results of the MSLT II trial  and various others. Would you be offered immunotherapy if you refused the dissection? Also ultra sound surveillance seem to be superior to clinical examinatinon by a clinician- would that be offered as safe non invasive and no radiation. 

                There are no right or wrong choices here given the evidence- but I would try to check out your surgeons experience with the laproscopic procedure- as results are likely to be better the more he does.

                Best wishes

                Deb

                  • February 16, 2017 at 1:07 pm
                  JustJaren
                  Participant

                    Thanks for your reply Deb. My second opinion is with a mel specialist at Emory. He teaches the lap technique locally, has performed quite a few. His office claims to have access to preliminary data to MSLT II. We shall see. 

                    I have read that with lapro they don't get as 'clean' but my sentinel had 4 cancer cells on the way IN to the node, Statistically, on average, I have an 80% chance there is no more involvement. Hoping that since there were only 4 cancer cells on the way in, that was it and further surgery will not be recommended by this specialist. (Delmar, Emory).

                    Thanks for the response and link. My original was only .86. I beat myself up daily, wishing I had gone for a skin check sooner, as recommended. sad

                    • February 16, 2017 at 2:03 pm
                    debwray
                    Participant

                      hi,

                      Don't beat yourself up. It changes little except making you feel bad…

                      Sounds like you will be getting expert well informed advice.. I had the bigger procedure including pelvis- that bit laproscopically, but it was macroscopic node involvement in the groin and  still ended up with a recurrence and lymphoedema. We use the stats to guide us- but they predict but don't determine individual outcomes. You just have to find what treatment you can be reconciled to and sometimes that is determined by stats, and confidence in the skills of your surgeon. Think the laproscopic procedure is trickier and they have to extract the pad via one of the ports..

                      Good luck whatever you decide..

                      Deb 

                      • February 24, 2017 at 2:51 am
                      Hriggenbach
                      Participant

                        I had it done 1/19 I had complications but that is a risk with and surgery but I've spoken with quite a few people at the hospital who had no issues great healing time a matter of 2-3 days and absolutely no pain. 

                        • February 16, 2017 at 2:03 pm
                        debwray
                        Participant

                          hi,

                          Don't beat yourself up. It changes little except making you feel bad…

                          Sounds like you will be getting expert well informed advice.. I had the bigger procedure including pelvis- that bit laproscopically, but it was macroscopic node involvement in the groin and  still ended up with a recurrence and lymphoedema. We use the stats to guide us- but they predict but don't determine individual outcomes. You just have to find what treatment you can be reconciled to and sometimes that is determined by stats, and confidence in the skills of your surgeon. Think the laproscopic procedure is trickier and they have to extract the pad via one of the ports..

                          Good luck whatever you decide..

                          Deb 

                          • February 16, 2017 at 1:07 pm
                          JustJaren
                          Participant

                            Thanks for your reply Deb. My second opinion is with a mel specialist at Emory. He teaches the lap technique locally, has performed quite a few. His office claims to have access to preliminary data to MSLT II. We shall see. 

                            I have read that with lapro they don't get as 'clean' but my sentinel had 4 cancer cells on the way IN to the node, Statistically, on average, I have an 80% chance there is no more involvement. Hoping that since there were only 4 cancer cells on the way in, that was it and further surgery will not be recommended by this specialist. (Delmar, Emory).

                            Thanks for the response and link. My original was only .86. I beat myself up daily, wishing I had gone for a skin check sooner, as recommended. sad

                          • February 16, 2017 at 12:41 pm
                          debwray
                          Participant

                            Link as promised,   https://www.nice.org.uk/guidance/ipg398/evidence/overview-495911773

                            More info if you plough through the references. Groin dissection is difficult as they remove the fat pad where they expect the nodes to be.. but some may fall outside the expected pattern,

                            Think you have had the partial knee replacement but depending on how long ago this was swelling should have settled. The bigger issue seems to be with more horizontal scars that disrupt the lymph flow.   I know you are hovering on the pos and cons of this procedure. Would say if the positive node was enlarged and full of melanoma- prob best to go for it – but it is much more finely balanced where the traces are microscopic, and the medical community are also divided whist awaiting the results of the MSLT II trial  and various others. Would you be offered immunotherapy if you refused the dissection? Also ultra sound surveillance seem to be superior to clinical examinatinon by a clinician- would that be offered as safe non invasive and no radiation. 

                            There are no right or wrong choices here given the evidence- but I would try to check out your surgeons experience with the laproscopic procedure- as results are likely to be better the more he does.

                            Best wishes

                            Deb

                        Viewing 4 reply threads
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