Frequently Asked Questions: Robotic RPLND
General Questions
Q: What is the difference between Robotic and Open RPLND? A: "Open" RPLND requires a large incision (up to 12 inches) down the middle of the abdomen. Robotic RPLND uses 4–6 small "keyhole" incisions. Through these small ports, the surgeon uses robotic arms to perform the same operation. The robotic approach typically results in significantly less pain, less blood loss, a shorter hospital stay, and a faster return to normal activities.
Q: Does the robot perform the surgery by itself? A: No. The robot is a tool that is 100% controlled by your surgeon at all times. It cannot make decisions or move on its own. It simply translates the surgeon’s hand movements into smaller, more precise movements inside the body.
Q: Will I need chemotherapy if I have this surgery? A: That depends on what we find. The surgery helps us "stage" the cancer accurately.
If the lymph nodes are negative (no cancer found), you may avoid chemotherapy entirely.
If the nodes are positive, your doctor will discuss whether observation or a short course of chemotherapy is needed to ensure all cancer cells are eliminated.
Recovery & Lifestyle
Q: How long will I stay in the hospital? A: Most patients undergoing Robotic RPLND are discharged within 24 to 48 hours. In contrast, open surgery patients often stay for 4–5 days.
Q: When can I return to work? A: This depends on your job.
Desk jobs: Most patients return in 2–3 weeks.
Manual labor/Heavy lifting: You must wait 4–6 weeks to allow the abdominal muscles to fully heal and prevent hernias.
Q: Why do I need to follow a low-fat diet after surgery? A: The lymphatic system transports fats from your diet. After lymph nodes are removed, eating fatty foods too soon can cause lymphatic fluid to leak into the abdomen (chylous ascites). We recommend a strict low-fat diet for 2–4 weeks post-surgery to let the internal tissues heal.
Q: When can I drive? A: You may drive when you are no longer taking narcotic pain medication and can comfortably stomp on the brake pedal in an emergency without pain (usually 1–2 weeks).
Side Effects & Function
Q: Will this surgery affect my ability to get an erection? A: No. The nerves that control erections are generally not affected by this surgery. You should be able to have erections just as you did before the procedure.
Q: Will this surgery affect my fertility (ability to father children)? A: The main risk is "retrograde ejaculation" (where semen goes into the bladder instead of coming out). This happens if the nerves controlling ejaculation are damaged. However, we utilize a Nerve-Sparing Technique whenever safe. This preserves normal ejaculation in the vast majority of patients. If retrograde ejaculation does occur, it is not harmful to your health, but it does make natural conception difficult (though IVF is still possible).
Q: Will I have a large scar? A: No. Unlike the large zipper-like scar from open surgery, Robotic RPLND leaves only small, scattered scars that fade significantly over time.