Name of the Procedure:

Orchiectomy, radical, for tumor; with abdominal exploration (Radical Orchiectomy)

Summary

A radical orchiectomy with abdominal exploration is a surgical procedure where one or both testicles are removed along with an examination of the abdominal cavity. This is typically done to treat testicular cancer that may have spread to abdominal lymph nodes.

Purpose

This procedure addresses testicular cancer, particularly when the cancer has spread beyond the testes. The goal is to remove cancerous tissue and to check for and possibly remove any cancer that has spread to abdominal lymph nodes.

Indications

• Diagnosed testicular cancer.
• Suspicion of metastatic cancer spread.
• Persistent or recurrent testicular tumors.
• Elevated tumor markers or imaging studies suggesting cancer spread.

Preparation

• Fasting typically required 8 hours before surgery.
• Blood tests, imaging studies (CT scan or MRI), and EKG if necessary.
• Discontinue certain medications, especially blood thinners, as per doctor’s advice.
• Pre-operative consultation with anesthesiologist.

Procedure Description

1. The patient is placed under general anesthesia.
2. An incision is made in the lower abdomen.
3. The spermatic cord and testicle are identified and removed.
4. Abdominal exploration is performed to examine and possibly remove affected lymph nodes.
5. The incisions are closed with sutures or staples.
6. The removed tissue is sent to pathology for further examination.

Tools:

• Scalpels, retractors, surgical scissors.
• Anesthesia equipment.
• Laparoscopic or open surgery tools, depending on the case.

Duration

The procedure typically takes 2 to 3 hours.

Setting

The procedure is performed in a hospital operating room.

Personnel

• Urologist or Oncologist Surgeon
• Surgical Nurses
• Anesthesiologist
• Operating Room Technicians

Risks and Complications

• Infection
• Bleeding
• Reaction to anesthesia
• Damage to surrounding organs or structures
• Blood clots
• Long-term hormonal changes if both testicles are removed

Benefits

• Removal of primary cancer site.
• Potential removal of metastatic cancer.
• Increased chance of survival and reduction of cancer recurrence.
• Immediate benefits realized post-surgery, though full benefits may take weeks to months.

Recovery

• Hospital stay of a few days post-surgery.
• Pain management with prescribed medications.
• Gradual return to normal activities within 4-6 weeks.
• Avoid heavy lifting and strenuous activities for several weeks.
• Follow-up visits for wound care and further cancer treatments if needed.

Alternatives

• Radiation therapy, especially if cancer has not spread extensively.
• Chemotherapy alone or as an adjunct to surgery.
• Surveillance and regular monitoring in early-stage cancer cases.

Patient Experience

• The patient will be under general anesthesia and will not experience pain during the surgery.
• Post-operative pain managed with medications.
• Discomfort and limited mobility during initial recovery period.
• Emotional and psychological impact of testicle removal, support and counseling may be beneficial.