Name of the Procedure:

Abdominal Lymphadenectomy, Regional, Including Celiac, Gastric, Portal, Peripancreatic, With or Without Para-Aortic and Vena Caval Nodes

Summary

An abdominal lymphadenectomy is a surgical procedure where lymph nodes within the abdominal cavity are removed. This can include nodes around major blood vessels and organs such as the celiac, gastric, portal, peripancreatic areas, and sometimes the para-aortic and vena caval nodes.

Purpose

The procedure is primarily used to treat cancer that has spread to the lymph nodes in the abdominal region. By removing the affected lymph nodes, the chances of the cancer spreading further can be reduced. It also helps in staging the cancer, determining the extent of its spread, and planning further treatment strategies.

Indications

• Presence of cancer in the abdominal lymph nodes
• Abnormal lymph node enlargement detected via imaging
• Symptoms like unexplained weight loss, abdominal pain, or persistent fatigue
• Lymph nodes showing signs of malignancy on biopsy

Preparation

• Patients may be required to fast for 8-12 hours before the procedure.
• Instructions for medication adjustments, especially blood thinners, will be provided.
• Preoperative evaluations, including blood tests, imaging studies, and possibly a biopsy of the lymph nodes, will be conducted.

Procedure Description

• The patient is administered general anesthesia.
• A surgeon makes an incision in the abdominal area.
• Using specialized surgical tools, the affected lymph nodes near the celiac, gastric, portal, peripancreatic regions, and possibly the para-aortic and vena cava, are identified and carefully removed.
• The incision is then closed with sutures or staples and covered with a sterile dressing.

Duration

The procedure typically takes between 2 to 4 hours, depending on the extent of the surgery and the patient's specific condition.

Setting

This surgery is performed in a hospital operating room.

Personnel

• Lead surgeon
• Surgical assistants and nurses
• Anesthesiologist
• Operating room technicians

Risks and Complications

• Infection
• Bleeding
• Injury to surrounding organs or blood vessels
• Lymphedema (swelling due to lymph fluid accumulation)
• Blood clots
• Reaction to anesthesia

Benefits

• Potential reduction in cancer spread
• More accurate cancer staging
• Improved planning for subsequent treatments
• Relief from cancer-related symptoms

Recovery

• Hospital stay of a few days post-surgery.
• Pain management through prescribed medications.
• Instructions on wound care and activity restrictions.
• Follow-up appointments for monitoring recovery and possible additional treatments like chemotherapy or radiation.

Alternatives

• Chemotherapy or radiation without surgery
• Minimally invasive surgical techniques (if applicable)
• Watchful waiting for non-symptomatic cases

Patient Experience

• The patient will be under anesthesia and not feel any pain during the procedure.
• Postoperative pain and discomfort managed through medications.
• Gradual return to normal activities over several weeks with specific activity restrictions to aid in healing.

Pain management and comfort measures such as gradual mobilization and physical therapy may be advised to facilitate a smooth recovery.