Retroperitoneal lymph node dissection: the past, present, and future, a review

Abstract

Testicular cancer is a malignancy that impacts young men worldwide. The modern treatment of testicular cancer has evolved due to innovations in medical approaches and surgical techniques. The retroperitoneal lymph node dissection (RPLND) is an integral component in the treatment of testicular cancer. We aim to highlight the advances in surgical approaches and oncologic considerations noted over the past century. Once recognized as a highly morbid procedure, innovations in the understanding of anatomy and minimally invasive approaches have greatly improved patient outcomes. In addition to surgical approaches, we describe oncologic principles associated with modern dissection templates for both non-seminomatous germ cell tumors as well as more recent indications for surgery in seminomatous germ cell tumors. The overall goal of this review is to provide a summary in the utility and recent advances in RPLND techniques.