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Patients with low-stage (stage I or stage II) nonseminomatous testicular cancer tumors often elect to undergo further surgery to remove the lymph nodes in the retroperitoneum. Retroperitoneal lymph node dissection (RPLND) is both diagnostic and therapeutic, and a minimally invasive approach is the procedure of choice at the Siteman Cancer Center for low-stage mixed malignant germ-cell testicular tumors and paratesticular rhabdomyosarcoma. 

Robert Figenshau, MD, Washington University Professor and director of minimally invasive urology at Barnes-Jewish Hospital, and his team are leaders in minimally invasive surgery. They employ laparoscopic surgical techniques for RPLND, performing the exact dissection and removal of the lymph nodes that is done as an open surgical procedure. This allows a much more rapid recovery when compared to the open surgical procedure. Most patients are discharged from the hospital the day after surgery and are fully recovered one month after the surgery. In a study published in early 2009, Figenshau had surgical results for RPLND similar to those of the open procedure in terms of absolute lymph node yield on microscopic examination. 

The peak incidence for testicular cancer is between the ages of 17 and 40. It is the most common solid tumor in this age group, with 8,000 new cases diagnosed annually in the United States. 
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